MEDICARE: MAURICE K ALLGEIER III 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	208000000X	Pediatrics Physician	KY37862	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000291437	OTHER	KY	ANTHEM BCBS

General Provider Information

NPI Number	:	1376546317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICE K ALLGEIER III MD

Provider Business Mailing Address
First Line	:	PO BOX 590293
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40295-0293
Country	:	US
Telephone Number	:	405-682-3303
Fax Number	:	405-792-8993

Provider Business Practice Location Address
First Line	:	6425 BARDSTOWN RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-3040
Country	:	US
Telephone Number	:	502-762-0498
Fax Number	:	502-762-0469

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/01/2016

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