Healthcare Provider Details

I. General information

NPI: 1205688520
Provider Name (Legal Business Name): EESHA MILIND KELKAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 HARRODSBURG RD STE 125
LEXINGTON KY
40504-3543
US

IV. Provider business mailing address

1407 PARK DE VILLE PL
COLUMBIA MO
65203-4639
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-4732
  • Fax: 859-323-6661
Mailing address:
  • Phone: 805-637-7660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: