Provider Demographics
NPI:1811936974
Name:VALLANCE, STEVEN R (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:VALLANCE
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 1:1 PHYSICIANS PARK
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4192
Mailing Address - Country:US
Mailing Address - Phone:502-223-7629
Mailing Address - Fax:502-223-7620
Practice Address - Street 1:1 PHYSICIANS PARK
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4192
Practice Address - Country:US
Practice Address - Phone:502-223-7629
Practice Address - Fax:502-223-7620
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY276402086S0129X, 208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYF36742OtherBLUEGRASS FAMILY HEALTH
020031810OtherRAILROAD MEDICARE
KY64276405Medicaid
163186200OtherU.S.. DEPT OF LABOR
KY610727156HOtherHUMANA PIN
KY000000062411OtherANTHEM PIN
KY37-00023OtherUNITED HEALTHCARE
KY610727156OtherCHA-HEALTH PIN
020031810OtherRAILROAD MEDICARE
KY610727156HOtherHUMANA PIN