Provider Demographics
NPI:1972580991
Name:MCCOMBS, RICK J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:J
Last Name:MCCOMBS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5750
Practice Address - Street 1:2605 KENTUCKY AVE STE 202
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3801
Practice Address - Country:US
Practice Address - Phone:270-415-4690
Practice Address - Fax:270-415-4691
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2020-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY29543207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0392811OtherMEDICARE GROUP PTAN
KY000000556927OtherANTHEM BCBS
KY6429543900Medicaid
KYP00611772OtherRAILROAD MEDICARE
KY000000556927OtherANTHEM BCBS