Provider Demographics
NPI:1558319178
Name:MARCUM, STEVEN R (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:MARCUM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2560 RICHMOND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1769
Mailing Address - Country:US
Mailing Address - Phone:859-277-1008
Mailing Address - Fax:859-277-1083
Practice Address - Street 1:2560 RICHMOND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1769
Practice Address - Country:US
Practice Address - Phone:859-277-1008
Practice Address - Fax:859-277-1083
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000320832OtherANTHEM
P00312619OtherRAILROAD MEDICARE
KY1053662031OtherGROUP NPI FOR STEVE MARCUM PT LLC
11386399OtherCAQH
KY87019170Medicaid
11386399OtherCAQH
KYK048520Medicare PIN
000000320832OtherANTHEM
KY1053662031OtherGROUP NPI FOR STEVE MARCUM PT LLC
KYK048523Medicare PIN