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Individual

DR. RICHARD FELLOWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-7661
(502) 629-5309
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 969-6552
(502) 969-3799

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
18377
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000544367
ANTHEM - KCR
KY
01
0000230291
HUMANA KCR
KY
01
00533031
MEDICARE - KCR
KY
05
100357970
IN
01
3505502
PASSPORT ADVTG - KCR
KY
01
50018757
PASSPORT - KCR
KY
05
64183775
KY
01
92158
SIHO - KCR
KY
Enumeration date
10/25/2006
Last updated
01/05/2009
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