Individual
TERRY A MCDANNOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-5427
(859) 341-0288
(859) 363-2140
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 341-0288
(859) 341-7482
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
023042
KY
207R00000X
Internal Medicine Physician
Primary
023042
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175984
ANTHEM
—
01
—
021036000
FEDERAL BLACK LUNG
—
01
—
0420592
UNITED HEALTHCARE
—
05
—
0584274
—
OH
01
—
0633858
AETNA
—
05
—
200916600
—
IN
01
—
310674100
US DEPT OF LABOR
—
01
—
50006695
PASSPORT
—
01
—
50010291
PASSPORT
—
05
—
64230428
—
KY
Enumeration date
08/22/2005
Last updated
09/10/2018
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