Healthcare Provider Details

I. General information

NPI: 1851586176
Provider Name (Legal Business Name): KATHRYN T RUTLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 DUPONT CIR STE 449
LOUISVILLE KY
40207-4812
US

IV. Provider business mailing address

4010 DUPONT CIR STE 449
LOUISVILLE KY
40207-4812
US

V. Phone/Fax

Practice location:
  • Phone: 866-744-1930
  • Fax:
Mailing address:
  • Phone: 866-744-1930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number36071
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number35C.003427
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number42754
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberP7560
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: