Provider Demographics
NPI:1386601342
Name:HADLEY, TERENCE J (MD)
Entity type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:J
Last Name:HADLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776347
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6347
Mailing Address - Country:US
Mailing Address - Phone:502-272-5052
Mailing Address - Fax:502-629-6217
Practice Address - Street 1:2355 POPLAR LEVEL RD
Practice Address - Street 2:SUITE 405
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1384
Practice Address - Country:US
Practice Address - Phone:502-272-5754
Practice Address - Fax:502-272-5339
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24912207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200058620Medicaid
KY830006323OtherRAILROAD MEDICARE
KY4045199OtherAETNA PROVIDER NUMB
KY1112298OtherPASSPORT PROVIDER NUMB
KY3964324OtherCIGNA PROVIDER NUMB
KY000000065300OtherANTHEM PROVIDER NUMB
KY000020583EOtherHUMANA PROVIDER NUMB
KY64249121Medicaid
KY830006323OtherRAILROAD MEDICARE
KY000000065300OtherANTHEM PROVIDER NUMB
KY000020583EOtherHUMANA PROVIDER NUMB
KY64249121Medicaid