Healthcare Provider Details

I. General information

NPI: 1316965700
Provider Name (Legal Business Name): CHERYL A. MCCLAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERYL A. KOCH M.D.

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 VERSAILLES RD
FRANKFORT KY
40601-3857
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 502-695-3946
  • Fax: 502-695-3847
Mailing address:
  • Phone: 305-500-2000
  • Fax: 843-277-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number71761
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number35C.001086
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number32948
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number01091882A
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32948
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: