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General NPI Number Information
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NPI Number | 1770586711
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Entity Type | Individual
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Provider Name | ROBERT A TODD M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 6400 DUTCHMANS PKWY STE 331
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City | LOUISVILLE
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State | KY
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Zip | 40205-3340
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Country | US
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Telephone | 502-896-0055
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Fax | 502-896-0836
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Provider Business Mailing Address
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Address Line | 6400 DUTCHMANS PKWY STE 331
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City | LOUISVILLE
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State | KY
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Zip | 40205-3344
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Country | US
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Telephone | 502-896-0055
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Fax | 502-896-0836
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20928
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License Number State | KY
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