Healthcare Provider Details

I. General information

NPI: 1669000345
Provider Name (Legal Business Name): JOHN DENNIS EHRHARDT JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 ABRAHAM FLEXNER WAY STE 700
LOUISVILLE KY
40202-3868
US

IV. Provider business mailing address

225 ABRAHAM FLEXNER WAY STE 850
LOUISVILLE KY
40202-3840
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-4200
  • Fax:
Mailing address:
  • Phone: 502-561-4266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01096967A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: