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BRENDON M COUGHTRY, MD – NPI #1669514840
Interventional Pain Medicine

NPI Profile for BRENDON M COUGHTRY in CAMPBELLSVILLE, KY.

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Contact Information

BRENDON M COUGHTRY, MD
99 WELLPARK LANE
STE 4
CAMPBELLSVILLE, KY  42718-4919
 Phone: 606-260-8613
 Fax: 859-977-2683
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

 208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for BRENDON M COUGHTRY · (Male)

NPI Number 1669514840
Status Active
Credentials MD
Entity Individual
Enumeration date 02/13/2007
Last updated 01/30/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • KY License # 42072
  • IN Medicaid 300012018
  • KY Medicaid 7100051000
  • VA Medicaid 30015488600001
  • WV Medicaid 1669514840
  • Other 9276417 AETNA PROVIDER ID NUMBER
  • Other 000001155521 ANTHEM PIN
  • Other CS1815900343 CARESOURCE PROVIDER ID NUMBER
  • Other 3406022 CIGNA PROVIDER ID NUMBER
  • Other 2950152 UNITED HEALTHCARE PROVIDER ID NUMBER
  • KY Other 102719KYIP AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
  • KY Other 1563218 WELLCARE OF KY PROVIDER ID NUMBER
Hospital affiliation(s)
  • PIKEVILLE MEDICAL CENTER - (Acute Care)
    911 BYPASS ROAD
    PIKEVILLE, KY 41501
  • SAINT JOSEPH HOSPITAL LONDON - (Acute Care)
    1001 SAINT JOSEPH LANE
    LONDON, KY 40741
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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