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General NPI Number Information
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NPI Number | 1124005038
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Entity Type | Individual
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Provider Name | KISHORKUMAR A DESAI M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 1830 HIGH ST STE A
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-1746
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Country | US
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Telephone | 270-885-3876
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Fax | 270-885-6349
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Provider Business Mailing Address
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Address Line | PO BOX 4300
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City | HOPKINSVILLE
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State | KY
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Zip | 42241-1148
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Country | US
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Telephone | 270-885-3876
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Fax | 270-885-6349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 38325
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 38463
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License Number State | KY
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