Healthcare Provider Details

I. General information

NPI: 1114448008
Provider Name (Legal Business Name): SONEY BASNYAT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PARK ST
BOWLING GREEN KY
42101-1795
US

IV. Provider business mailing address

250 PARK ST
BOWLING GREEN KY
42101-1795
US

V. Phone/Fax

Practice location:
  • Phone: 270-796-6540
  • Fax: 270-796-6576
Mailing address:
  • Phone: 270-796-6540
  • Fax: 270-796-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number0101271723
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101271723
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number56590
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: