Provider Demographics
NPI:1427117225
Name:TOLAR, RHEANEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RHEANEL
Middle Name:A
Last Name:TOLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:150 BRETT CHASE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-5706
Mailing Address - Country:US
Mailing Address - Phone:270-554-4820
Mailing Address - Fax:270-448-0300
Practice Address - Street 1:150 BRETT CHASE
Practice Address - Street 2:SUITE B
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-5706
Practice Address - Country:US
Practice Address - Phone:270-554-4820
Practice Address - Fax:270-448-0300
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY38713207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64089006Medicaid
KYH80472Medicare UPIN
KY64089006Medicaid