Provider Demographics
NPI:1144226598
Name:O'ROURKE, JAMES P (MD, FACS, FCCP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:O'ROURKE
Suffix:
Gender:M
Credentials:MD, FACS, FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 636961
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6961
Mailing Address - Country:US
Mailing Address - Phone:513-981-5130
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:1532 LONE OAK RD
Practice Address - Street 2:SUITE 445
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7913
Practice Address - Country:US
Practice Address - Phone:270-538-5830
Practice Address - Fax:270-538-5835
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28762208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64287626Medicaid
KYA97334Medicare UPIN
KY00931003Medicare PIN
KYP00731485OtherMEDICARE/ RAILROAD PTAN
KYA97334Medicare UPIN