Provider Demographics
NPI:1225030653
Name:VENHOFF, GEORGE D (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:D
Last Name:VENHOFF
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 1:6801 DIXIE HWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3913
Mailing Address - Country:US
Mailing Address - Phone:502-426-0606
Mailing Address - Fax:502-426-0604
Practice Address - Street 1:9520 ORMSBY STATION RD. SUITE 175
Practice Address - Street 2:PLAZA III HURSTBOURNE GREEN
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5021
Practice Address - Country:US
Practice Address - Phone:502-426-2261
Practice Address - Fax:502-426-6371
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64173834Medicaid
KYP00307421Medicare PIN
KY00546090Medicare Oscar/Certification
KY64173834Medicaid