Healthcare Provider Details

I. General information

NPI: 1356320840
Provider Name (Legal Business Name): STEPHEN A CAWOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 DUTCHMANS LN
LOUISVILLE KY
40207-4714
US

IV. Provider business mailing address

100 MALLARD CREEK RD SUITE 406
LOUISVILLE KY
40207-4194
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-1084
  • Fax: 502-894-1324
Mailing address:
  • Phone: 502-896-1881
  • Fax: 502-895-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number31279
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: