Healthcare Provider Details

I. General information

NPI: 1285740175
Provider Name (Legal Business Name): EASTERN KY ALLERGY AND ASTHMA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11021 MAIN ST
MARTIN KY
41649
US

IV. Provider business mailing address

PO BOX 1825
PRESTONBURG KY
41653
US

V. Phone/Fax

Practice location:
  • Phone: 606-285-9222
  • Fax: 606-285-9223
Mailing address:
  • Phone: 606-285-9222
  • Fax: 606-285-9223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number36402
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36402
License Number StateKY

VIII. Authorized Official

Name: SUNIL K SARAF
Title or Position: PRESIDENT
Credential: MD
Phone: 606-285-9222