Healthcare Provider Details

I. General information

NPI: 1689060295
Provider Name (Legal Business Name): TAKAAKI KOBAYASHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 BEAUMONT CENTRE CIR STE 100
LEXINGTON KY
40513-1959
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5544
  • Fax: 859-257-9286
Mailing address:
  • Phone: 193-567-7740
  • Fax: 319-356-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-45061
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD-45061
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number58898
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: