Healthcare Provider Details

I. General information

NPI: 1124174503
Provider Name (Legal Business Name): ERIC SCOTT CAHILL MS CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 EASTERN PKWY BUILDING B
LOUISVILLE KY
40217-1566
US

IV. Provider business mailing address

4814 BELLEVUE AVE
LOUISVILLE KY
40215-2412
US

V. Phone/Fax

Practice location:
  • Phone: 502-595-4459
  • Fax:
Mailing address:
  • Phone: 502-261-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberKY-0463
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: