Provider Demographics
NPI:1447888185
Name:KOHL, MADISON JEAN (DO)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:JEAN
Last Name:KOHL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:JEAN
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 ROSE STREET ANESTHESIOLOGY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-218-0069
Mailing Address - Fax:859-323-1080
Practice Address - Street 1:800 ROSE STREET ANESTHESIOLOGY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-218-0069
Practice Address - Fax:859-323-1080
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR5341207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology