Provider Demographics
NPI:1134181993
Name:MCGAHAN, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:MCGAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7052 SOLUTION CTR
Mailing Address - Street 2:CANCER CENTER OF SOUTHERN KENTUCKY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-7000
Mailing Address - Country:US
Mailing Address - Phone:270-904-0845
Mailing Address - Fax:270-904-2651
Practice Address - Street 1:1728 ROCKINGHAM AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3379
Practice Address - Country:US
Practice Address - Phone:270-904-0845
Practice Address - Fax:270-904-2651
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272982085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY360001764OtherRR MEDICARE
KY22000000049572OtherBC/BS
KY64272982Medicaid
KY64272982Medicaid