Healthcare Provider Details

I. General information

NPI: 1740479062
Provider Name (Legal Business Name): VISHAL GOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 EASTERN BYP SUITE 17
RICHMOND KY
40475-2415
US

IV. Provider business mailing address

PO BOX 1477
RICHMOND KY
40476-1477
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-4797
  • Fax: 859-626-0519
Mailing address:
  • Phone: 859-626-4797
  • Fax: 859-626-0519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberKY34522
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberKY34522
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberKY34522
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberKY34522
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: