Provider Demographics
NPI:1356472971
Name:POSTON, CORNELIA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CORNELIA
Middle Name:MARIA
Last Name:POSTON
Suffix:
Gender:F
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4420 DIXIE HWY STE 128
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2996
Practice Address - Country:US
Practice Address - Phone:502-449-6400
Practice Address - Fax:502-449-6401
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP292207V00000X
KY43752207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201014130Medicaid
KY120612OtherSIHO - WS
KYP01048909OtherRAILROAD MEDICARE - WS
KY000000687705OtherANTHEM - WS
KY7100140620Medicaid
KY50030645OtherPASSPORT & PP ADVTG - WS
IN201014130Medicaid
KYP400031009Medicare PIN