Provider Demographics
NPI:1497752612
Name:MCHENDRIX, ROBERT G III (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:MCHENDRIX
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1866
Mailing Address - Country:US
Mailing Address - Phone:859-331-4777
Mailing Address - Fax:859-341-3133
Practice Address - Street 1:3126 DIXIE HWY
Practice Address - Street 2:SUITE 10
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1866
Practice Address - Country:US
Practice Address - Phone:859-331-4777
Practice Address - Fax:859-341-3133
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00125213E00000X, 213ES0131X
KYK0125213ER0200X, 335E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80001258Medicaid
OH0245354Medicaid
KY0247710001OtherMEDICARE DME
KY958792OtherAETNA
KY000000033272OtherANTHEM BCBS
KY27-80420OtherUNITED HEALTHCARE
KY406480106OtherRAILROAD MEDICARE UHC
KYK0125OtherHUMANA/CHOICE CARE
KY406480106OtherRAILROAD MEDICARE UHC
OH0245354Medicaid
KYT53912Medicare UPIN
KY2014001Medicare ID - Type Unspecified