Healthcare Provider Details

I. General information

NPI: 1275227233
Provider Name (Legal Business Name): ASNA SHANTILAL PATEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-0200
US

IV. Provider business mailing address

205 CHARLES T WETHINGTON BUILDING
LEXINGTON KY
40536-0200
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6047
  • Fax: 859-257-3873
Mailing address:
  • Phone: 859-257-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3317
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA3317
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA3317
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: