Provider Demographics
NPI:1184680068
Name:SPALDING, STUART D (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:D
Last Name:SPALDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:10216 TAYLORSVILLE RD STE 500
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-3617
Practice Address - Country:US
Practice Address - Phone:502-928-1050
Practice Address - Fax:502-928-1051
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000556358OtherANTHEM
KY64066897Medicaid
KY00546036Medicare Oscar/Certification
KY000000556358OtherANTHEM
KY64066897Medicaid