Provider Demographics
NPI:1982691028
Name:BEHR, MARK R (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:BEHR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3101 BRECKENRIDGE LN
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2742
Mailing Address - Country:US
Mailing Address - Phone:502-458-7400
Mailing Address - Fax:502-458-7449
Practice Address - Street 1:3101 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 1A
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2742
Practice Address - Country:US
Practice Address - Phone:502-458-7400
Practice Address - Fax:502-458-7449
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2009-02-05
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Provider Licenses
StateLicense IDTaxonomies
KY26530207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100345630Medicaid
KY64265309Medicaid
KY1269926Medicare Oscar/Certification
KY64265309Medicaid
IN100345630Medicaid