Provider Demographics
NPI:1356320840
Name:CAWOOD, STEPHEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:CAWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MALLARD CREEK RD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4194
Mailing Address - Country:US
Mailing Address - Phone:502-896-1881
Mailing Address - Fax:502-895-4586
Practice Address - Street 1:4001 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4714
Practice Address - Country:US
Practice Address - Phone:502-893-1084
Practice Address - Fax:502-894-1324
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2014-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY31279207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000057464OtherANTHEM PROV ID#
KY1054503OtherPASSPORT PROV ID#
KY64312796Medicaid
KY000000057464OtherANTHEM PROV ID#
KY1054503OtherPASSPORT PROV ID#