Healthcare Provider Details

I. General information

NPI: 1922108844
Provider Name (Legal Business Name): JAY VALLABH NAROLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 SOUTH MAYO TRAIL NOVA COMPLEX STE 101
PIKEVILLE KY
41501
US

IV. Provider business mailing address

PO BOX 2470
PIKEVILLE KY
41502
US

V. Phone/Fax

Practice location:
  • Phone: 606-432-7233
  • Fax: 606-432-7255
Mailing address:
  • Phone: 606-432-7233
  • Fax: 606-432-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberKY29549
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: