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Contact Information

RON E CREQUE JR, MD
101 STONECREST ROAD
SUITE 3
SHELBYVILLE, KY40065
 Phone: 502-633-5565
 Fax: 502-633-5154
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for RON E CREQUE JR · (Male)

NPI # 1194717397
Status Active
Credentials MD
Entity Individual
Enumeration date 08/16/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • KY License # 36516
  • KY Medicaid 64030653
  • Other 000000200138 ANTHEM
Hospital affiliation(s)
  • BAPTIST HOSPITAL EAST - (Acute Care)
    4000 KRESGE WAY
    LOUISVILLE, KY 40207
  • JEWISH HOSPITAL - SHELBYVILLE - (Acute Care)
    727 HOSPITAL DRIVE
    SHELBYVILLE, KY 40065
  • NORTON HOSPITALS INC - (Acute Care)
    200 EAST CHESTNUT STREET
    LOUISVILLE, KY 40202
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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