MEDICARE: MR. CHAD PHILIP SECOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	35860	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00145931	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7864717	OTHER	CIGNA
4	0000000329395	OTHER	ANTHEM BCBS
5	10-00015	OTHER	UNITED HEALTHCARE
6	50005766	OTHER	PASSPORT HEALTHCARE

General Provider Information

NPI Number	:	1225038177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD PHILIP SECOR MD

Provider Business Mailing Address
First Line	:	4003 KRESGE WAY
Second Line	:	STE 227
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4652
Country	:	US
Telephone Number	:	502-893-3342
Fax Number	:	502-893-3342

Provider Business Practice Location Address
First Line	:	4003 KRESGE WAY
Second Line	:	STE 227
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4652
Country	:	US
Telephone Number	:	502-893-3342
Fax Number	:	502-893-9575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	02/19/2025

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Directions to “ MR. CHAD PHILIP SECOR MD” Practice Location

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