Provider Demographics
NPI:1699861831
Name:BUCSHON, KATHRYN SUE REINHARDT (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:SUE REINHARDT
Last Name:BUCSHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:S
Other - Last Name:REINHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3366
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3366
Mailing Address - Country:US
Mailing Address - Phone:812-450-2240
Mailing Address - Fax:812-450-2710
Practice Address - Street 1:12613 CHESDIN LANDING DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838-3231
Practice Address - Country:US
Practice Address - Phone:804-301-4830
Practice Address - Fax:804-863-4626
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049634A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000216536OtherBCBS PIN
IN000000500998OtherBCBS - DEACONESS GATEWAY
IN200271630Medicaid
INP00365276OtherRR MEDICARE
KY64043730Medicaid
IN000000500998OtherBCBS - DEACONESS GATEWAY
INP00365276OtherRR MEDICARE