Provider Demographics
NPI:1386677797
Name:EIFERMAN, RICHARD ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANDREW
Last Name:EIFERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6400 DUTCHMANS PARKWAY
Mailing Address - Street 2:STE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205
Mailing Address - Country:US
Mailing Address - Phone:502-895-4200
Mailing Address - Fax:502-895-0819
Practice Address - Street 1:6400 DUTCHMANS PARKWAY
Practice Address - Street 2:STE 220
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205
Practice Address - Country:US
Practice Address - Phone:502-895-4200
Practice Address - Fax:502-895-0819
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY19091207W00000X
IN01050235A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000042789OtherANTHEM
KY64190911Medicaid
KY1007402Medicare ID - Type Unspecified
KY64190911Medicaid