Provider Demographics
NPI:1235177015
Name:MERHAR, GARY LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LOUIS
Last Name:MERHAR
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:UNIVERSITY OF KENTUCKY RADIOLOGY
Mailing Address - Street 2:800 ROSE STREET HX 316
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-5069
Mailing Address - Fax:853-257-4457
Practice Address - Street 1:UNIVERSITY OF KENTUCKY RADIOLOGY
Practice Address - Street 2:800 ROSE STREET HX 316
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-5069
Practice Address - Fax:853-257-4457
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044808M2085R0202X
KY235362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64784267Medicaid
IN200039040AMedicaid
OH0491301Medicaid
OHP00352394Medicare PIN
KYK012050Medicare PIN
KY64784267Medicaid
OH0491301Medicaid