Provider Demographics
NPI:1245295310
Name:CATLETT, DAVID N (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:CATLETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2355 POPLAR LEVEL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1395
Practice Address - Country:US
Practice Address - Phone:502-636-7444
Practice Address - Fax:502-636-7340
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY38986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000057119MOtherHUMANA - NCMA
KY000000705096OtherANTHEM-NCMA
KY50007288OtherPASSPORT MEDICAID MGD CAR
KY64071905Medicaid
IN201018690Medicaid
5993620OtherCIGNA-NCMA
KY000000364690OtherANTHUM BCBS
KY125062OtherSIHO-NCMA
KYP00374090OtherRAILROAD MEDICARE
KYP00925543OtherMEDICARE RAILROAD KY - NCMA
KY50032648OtherPASSPORT-NCMA
KYP400042995Medicare PIN
KY50032648OtherPASSPORT-NCMA
IN201018690Medicaid