Healthcare Provider Details

I. General information

NPI: 1720051865
Provider Name (Legal Business Name): RANJHAN K GOPANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 11TH ST
CARROLLTON KY
41008-1435
US

IV. Provider business mailing address

309 11TH ST
CARROLLTON KY
41008-1435
US

V. Phone/Fax

Practice location:
  • Phone: 502-732-3280
  • Fax: 502-575-6234
Mailing address:
  • Phone: 502-732-3280
  • Fax: 502-575-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39292
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: