Provider Demographics
NPI:1629071006
Name:CORRIGAN, CYNTHIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 BISHOP LN STE 1018
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1928
Mailing Address - Country:US
Mailing Address - Phone:502-456-6211
Mailing Address - Fax:502-456-4440
Practice Address - Street 1:1850 BLUEGRASS AVE
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1161
Practice Address - Country:US
Practice Address - Phone:502-456-6212
Practice Address - Fax:502-456-4440
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25223207ZB0001X, 207ZP0102X
IN01038033A207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50015855OtherPASSPORT
KYP00425443OtherMEDICARE RR
KY000000537871OtherANTHEM
KY2873451000OtherPASSPORT ADVANTAGE
IN200044900AMedicaid
KY64252232Medicaid
KY00292003Medicare PIN
IN200044900AMedicaid
KY64252232Medicaid