Provider Demographics
NPI:1912995721
Name:FUCHS, GARY LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LEWIS
Last Name:FUCHS
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 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-585-4321
Mailing Address - Fax:502-566-6338
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 305
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1846
Practice Address - Country:US
Practice Address - Phone:502-585-4321
Practice Address - Fax:502-566-6338
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039859A207RC0000X
AZ25952207RC0000X
KY19483207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200008570Medicaid
KY060066387OtherRAILROAD MEDICARE
KY64194830Medicaid
KYP00336121OtherRAILROAD MEDICARE
IN060014165OtherRAILROAD MEDICARE
KYP00336121OtherRAILROAD MEDICARE
KY00546062Medicare Oscar/Certification
KY0640902Medicare PIN
KY00308005Medicare PIN
KY64194830Medicaid
IN060014165OtherRAILROAD MEDICARE
KY00314005Medicare PIN
KY1600107Medicare PIN
KY00311005Medicare PIN
KY060066387OtherRAILROAD MEDICARE
KY0289303Medicare PIN
IN228550FMedicare PIN
KY00312005Medicare PIN
KYP00612945Medicare PIN
KY0690807Medicare PIN
KY1273204Medicare PIN
KY00310005Medicare PIN
KY00309005Medicare PIN