Individual
DR. MATTHEW JACOB KOTLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-4000
(859) 301-4001
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-4000
(859) 301-4001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.130665
OH
207R00000X
Internal Medicine Physician
57.024319
OH
207RH0003X
Hematology & Oncology Physician
35.130665
OH
207RH0003X
Hematology & Oncology Physician
Primary
54040
KY
207RX0202X
Medical Oncology Physician
54040
KY
Other
Enumeration date
03/29/2014
Last updated
05/14/2021
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