Healthcare Provider Details

I. General information

NPI: 1801081864
Provider Name (Legal Business Name): BIJAL ABHEER JAYAKAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BIJAL M MEHTA M.D.

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 FOUNTAIN CT SUITE 210
LEXINGTON KY
40509-2694
US

IV. Provider business mailing address

100 E LIBERTY ST SUITE 800
LOUISVILLE KY
40202-1434
US

V. Phone/Fax

Practice location:
  • Phone: 859-629-7265
  • Fax: 859-629-7266
Mailing address:
  • Phone:
  • Fax: 606-330-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number48718
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: