| Doctor Name: | JAMES R CICCHIELLO |
| NPI Number: | 1730144296 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 26217 |
| Business Practice Address: | 7926 Preston Hwy Ste 210 Louisville, KY - 402193848 |
| Business Phone Number: | 5029668675 |
| Business Fax Number: | 5029668836 |
| Mailing Address: | Po Box 950202, LOUISVILLE |
| State: | KY |
| Postal Code: | 402950202 |
| Phone Number: | 5025889490 |
| Fax Number: | 5022725116 |
| NPI Enumeration Date: | 04/19/2006 |
| NPI Last Update Date: | 11/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 26217 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |