Provider Demographics
NPI:1477535110
Name:CALHOUN, ROYCE FORD II (MD)
Entity Type:Individual
Prefix:DR
First Name:ROYCE
Middle Name:FORD
Last Name:CALHOUN
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:2300 CHAMBER CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:LAKESIDE PARK
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1686
Mailing Address - Country:US
Mailing Address - Phone:859-301-9010
Mailing Address - Fax:859-301-9018
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:859-301-2465
Practice Address - Fax:859-301-4941
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2020-10-29
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Provider Licenses
StateLicense IDTaxonomies
KY48735208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0157044Medicaid
IN200438920Medicaid
CA00G871490OtherMEDICARE PTAN - REGENTS OF THE UNIVERSITY OF CALIFORNIA
CA1477535110Medicaid
KY7100400970Medicaid
OH0157044Medicaid
CA00G871490OtherMEDICARE PTAN - REGENTS OF THE UNIVERSITY OF CALIFORNIA
KY7100400970Medicaid