Healthcare Provider Details

I. General information

NPI: 1821126970
Provider Name (Legal Business Name): VIPUL D BRAHMBHATT M.D.,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 SPRING ST
JEFFERSONVILLE IN
47130-3639
US

IV. Provider business mailing address

930 SPRING ST
JEFFERSONVILLE IN
47130-3639
US

V. Phone/Fax

Practice location:
  • Phone: 812-288-6660
  • Fax: 812-283-5975
Mailing address:
  • Phone: 812-288-6660
  • Fax: 812-283-5975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VIPUL D BRAHMBHATT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 812-288-6660