Dr Ian Spencer Mutchnick, MD | |
210 E Gray St, Suite 1102, Louisville, KY 40202-3900 | |
(502) 322-5714 | |
Not Available |
Full Name | Dr Ian Spencer Mutchnick |
---|---|
Gender | Male |
Speciality | Neurological Surgery |
Location | 210 E Gray St, Louisville, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295954386 | NPI | - | NPPES |
000000642043 | Other | KY | ANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY |
3810329 | Other | KY | CIGNA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY |
50026300 | Other | KY | PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY |
108520 | Other | KY | SIHO |
200967320 | Medicaid | IN | |
3746249000 | Other | KY | PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY |
200967320 | Other | KY | ANTHEM INDIANA MEDICAID- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY |
7100090630 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207T00000X | Neurological Surgery | 095567 (Ohio) | Secondary |
207T00000X | Neurological Surgery | 43020 (Kentucky) | Primary |
Entity Name | Community Medical Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588614994 PECOS PAC ID: 7012811284 Enrollment ID: O20031120000656 |
Entity Name | Norton Childrens Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457999096 PECOS PAC ID: 3779917596 Enrollment ID: O20200102000758 |
Mailing Address | Practice Location Address |
---|---|
Dr Ian Spencer Mutchnick, MD Po Box 776879, Chicago, IL 60677-6879 Ph: (502) 588-9490 | Dr Ian Spencer Mutchnick, MD 210 E Gray St, Suite 1102, Louisville, KY 40202-3900 Ph: (502) 322-5714 |
Maxwell Boakye, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 220 Abraham Flexner Way Ste 1200, Louisville, KY 40202 Phone: 502-899-3623 | |
John Joseph Guarnaschelli, MD Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 234 E Gray St, Suite 768, Louisville, KY 40202 Phone: 502-584-4121 Fax: 502-584-6626 | |
Abigail Justine Rao, M.D. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 4950 Norton Healthcare Blvd Ste 205, Louisville, KY 40241 Phone: 502-394-6390 Fax: 502-394-6388 | |
Dr. Aurora Seaton Cruz, MD Neurological Surgery Medicare: Medicare Enrolled Practice Location: 4003 Kresge Way Ste 400, Louisville, KY 40207 Phone: 502-259-5955 Fax: 502-259-5953 | |
Dr. Maria Koutourousiou, M.D. Neurological Surgery Medicare: Not Enrolled in Medicare Practice Location: 200 Abraham Flexner Way, Se #1200, Louisville, KY 40202 Phone: 502-899-3623 Fax: 502-899-7970 | |
Nathaniel Todnem, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 3900 Kresge Way Ste 51, Louisville, KY 40207 Phone: 502-259-5955 | |
Norberto Omar Andaluz, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 220 Abraham Flexner Way Ste 1200, Louisville, KY 40202 Phone: 502-899-3623 Fax: 502-899-7970 |