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NPI Code Detail

MEDICARE: ROBERT A TODD M.D.

MEDICARE:   ROBERT A TODD  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician20928KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770586711
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT A TODD M.D.
Provider Business Mailing Address
First Line : 6400 DUTCHMANS PKWY
Second Line : STE 331
City : LOUISVILLE
State : KY
Zip : 40205-3344
Country : US
Telephone Number : 502-896-0055
Fax Number : 502-896-0836
Provider Business Practice Location Address
First Line : 6400 DUTCHMANS PKWY
Second Line : STE 331
City : LOUISVILLE
State : KY
Zip : 40205-3340
Country : US
Telephone Number : 502-896-0055
Fax Number : 502-896-0836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 12/17/2007

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