MEDICARE: DR. LLOYD ROSS TAUSTINE 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	207W00000X	Ophthalmology Physician	19646	KY
2	207W00000X	Ophthalmology Physician	28394	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	180012783	OTHER	KY	MEDICARE RAILROAD
8	180004025	OTHER	IN	MEDICARE RAILROAD

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	I005632	OTHER		TRICARE INDIANA OFFICE
3	K001342	OTHER		TRICARE KENTUCKY OFFICE
4	000000042393	OTHER	IN	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	917333	OTHER		BLOCK VISION
10	0800022	OTHER		UNITED HEALTHCARE
11	000000062217	OTHER	KY	ANTHEM
12	4012921	OTHER		AETNA
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437151099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LLOYD ROSS TAUSTINE MD

Provider Business Mailing Address
First Line	:	6400 DUTCHMANS PKWY STE 125
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3342
Country	:	US
Telephone Number	:	502-896-8700
Fax Number	:	502-896-0813

Provider Business Practice Location Address
First Line	:	1169 EASTERN PKWY STE 1211
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40217-1462
Country	:	US
Telephone Number	:	502-896-8700
Fax Number	:	502-896-0813

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	02/10/2023

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Directions to “ DR. LLOYD ROSS TAUSTINE MD” Practice Location

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