Provider Demographics
NPI:1306907688
Name:TAO, CATHY ANN (MD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:TAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 DUPONT CIRCLE
Mailing Address - Street 2:SUITE 565
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4888
Mailing Address - Country:US
Mailing Address - Phone:502-895-1611
Mailing Address - Fax:502-895-1611
Practice Address - Street 1:4010 DUPONT CIRCLE
Practice Address - Street 2:SUITE 565
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4888
Practice Address - Country:US
Practice Address - Phone:502-895-1611
Practice Address - Fax:502-895-1611
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64280019Medicaid
IN100376870Medicaid
IN100376870Medicaid
KYK118360Medicare PIN