Provider Demographics
NPI:1770633307
Name:YUHAS, PHILLIP BRADLEY (DC)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:BRADLEY
Last Name:YUHAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E JOHN ROWAN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2060
Mailing Address - Country:US
Mailing Address - Phone:502-331-0900
Mailing Address - Fax:502-331-0937
Practice Address - Street 1:1000 E JOHN ROWAN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2060
Practice Address - Country:US
Practice Address - Phone:502-331-0900
Practice Address - Fax:502-331-0937
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY623955OtherBLUEGRASS NETWORK
KY1214298OtherCHA HEALTH
KY4592OtherSTATE LICENSE
KY50004019OtherPASSPORT
KYCHOICE CAREOtherHUMANA
KY623955OtherACN
KY85002905Medicaid
KY000000306600OtherBLUE CROSS
KY17864897YUHOtherUNITED HEALTHCARE
KY623955OtherTHE MAIL HANDLERS BENEFIT
KY2445411000OtherPASSPORT ADVANTAGE
KY2445410000OtherPASSPORT ADVANTAGE GROUP
KY7963456OtherAETNA
KY0786801Medicare ID - Type UnspecifiedMEDICARE
KY623955OtherACN
KYU94644Medicare UPIN