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General NPI Number Information
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NPI Number | 1811989288
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Entity Type | Individual
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Provider Name | TERRY A MCDANNOLD MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 2900 CHANCELLOR DR
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-5427
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Country | US
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Telephone | 859-341-0288
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Fax | 859-363-2140
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Provider Business Mailing Address
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Address Line | PO BOX 635283
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City | CINCINNATI
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State | OH
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Zip | 45263-5283
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Country | US
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Telephone | 859-341-0288
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Fax | 859-341-7482
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 023042
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 023042
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License Number State | KY
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