Healthcare Provider Details

I. General information

NPI: 1538135033
Provider Name (Legal Business Name): MEENA S PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 FAIRGROUNDS RD
HARDINSBURG KY
40143
US

IV. Provider business mailing address

203 FAIRGROUNDS RD
HARDINSBURG KY
40143
US

V. Phone/Fax

Practice location:
  • Phone: 270-756-2171
  • Fax: 270-756-2855
Mailing address:
  • Phone: 270-756-2171
  • Fax: 270-756-2855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number21716
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: