Provider Demographics
NPI:1598707465
Name:MCBRIDE, ANTHONY D (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 BRECKENRIDGE ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-0839
Mailing Address - Country:US
Mailing Address - Phone:270-688-4270
Mailing Address - Fax:270-688-4279
Practice Address - Street 1:1000 BRECKENRIDGE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-0839
Practice Address - Country:US
Practice Address - Phone:270-688-4270
Practice Address - Fax:270-688-4279
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY44678207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100170750Medicaid
KYD98118Medicare UPIN
KYK007080Medicare PIN