Provider Demographics
NPI:1376546317
Name:ALLGEIER, MAURICE K III (MD)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:K
Last Name:ALLGEIER
Suffix:III
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:PO BOX 590293
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0293
Mailing Address - Country:US
Mailing Address - Phone:405-682-3303
Mailing Address - Fax:405-792-8993
Practice Address - Street 1:6425 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3040
Practice Address - Country:US
Practice Address - Phone:502-762-0498
Practice Address - Fax:502-762-0469
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY37862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64066251Medicaid
KY000000291437OtherANTHEM BCBS
KYI00943Medicare UPIN