Healthcare Provider Details

I. General information

NPI: 1104826239
Provider Name (Legal Business Name): RAJAN R. JOSHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAJAN R. JOSHI P.S.C.

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date: 03/22/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

2019 CORPORATE DR TOTAL LUNG CARE AND SLEEP CENTER
RICHMOND KY
40475-8884
US

IV. Provider business mailing address

2019 CORPORATE DR TOTAL LUNG CARE AND SLEEP CENTER
RICHMOND KY
40475-8884
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-8981
  • Fax: 859-624-3146
Mailing address:
  • Phone: 859-623-8981
  • Fax: 859-624-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number23841
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number23841
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: