MEDICARE: DR. VINCENT PAUL GENOVESE M.D.

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	207X00000X	Orthopaedic Surgery Physician	58998	MA
2	207X00000X	Orthopaedic Surgery Physician	40710	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P0039857	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000867	OTHER	MA	BLUECHIP
2	713792	OTHER	MA	TUFTS
3	0901010	OTHER	MA	UNITED HEALTH
4	79983	OTHER	MA	US HEALTH
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	000000508863	OTHER	KY	ANTHEM BLUE CROSS
8	0119098-003	OTHER	MA	CIGNA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	17311	OTHER	MA	PILGRIM

General Provider Information

NPI Number	:	1508822925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT PAUL GENOVESE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 23229
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42304-3229
Country	:	US
Telephone Number	:	270-377-0111
Fax Number	:	270-377-0113

Provider Business Practice Location Address
First Line	:	440 HOPKINSVILLE ST
Second Line	:	SUITE 2E
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1124
Country	:	US
Telephone Number	:	270-377-0111
Fax Number	:	270-377-0113

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	05/02/2019

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