Healthcare Provider Details

I. General information

NPI: 1487628954
Provider Name (Legal Business Name): BELA H BHATT-KOSHAL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 W UNION ST EXPRESSCARE
ATHENS OH
45701-2313
US

IV. Provider business mailing address

330 PARKS HALL
ATHENS OH
45701-1359
US

V. Phone/Fax

Practice location:
  • Phone: 740-594-2456
  • Fax: 740-594-9630
Mailing address:
  • Phone: 740-593-2487
  • Fax: 740-593-0626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number34-007345
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34007345
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: