Provider Demographics
NPI:1528157021
Name:CUTHRELL, WILLIAM VANCE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:VANCE
Last Name:CUTHRELL
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:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-272-5065
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:4123 DUTCHMANS LN
Practice Address - Street 2:SUITE 515
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4707
Practice Address - Country:US
Practice Address - Phone:502-899-6907
Practice Address - Fax:502-899-6905
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36520207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000571054OtherANTHEM- NORTON
KY019401OtherSIHO/NORTON
IN200376820Medicaid
KY64041213Medicaid
KY697312OtherCIGNA/NORTON
KY00533073Medicare PIN
KY200376820OtherMEDICARE/NORTON