Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Short, MD

Individual provider Psychiatry Physician · NPI 1629502604

Ethan Short, MD is a Psychiatry Physician in Louisville, Kentucky. Practices as a sole proprietor and works from 2 locations. Licensed in Indiana and Kentucky.

Licensed in
IN, KY
In the registry since
2017
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

228 Delmont Ave
Louisville, KY 40206-1025
Phone: (502) 619-0636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5722 Outer Loop, Louisville, KY 40219-4156 — (502) 492-7455

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 54489 (KY)
Psychiatry Physician Taxonomy 2084P0800X · Licence 01091358A (IN)
Psychiatry Physician Taxonomy 2084P0800X · Licence R4865 (KY)
General Practice Physician Taxonomy 208D00000X · Licence 54489 (KY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1629502604
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 17, 2017
Last updated in NPPESAugust 22, 2023
Certification dateAugust 22, 2023

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