=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194100529
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PRIYANKA OMPRAKASH YADAV MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2015
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 740 S LIMESTONE STE B101
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40536-3200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-323-5661
-----------------------------------------------------
Fax | 859-323-6411
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 740 S LIMESTONE STE B101
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40536-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-323-5661
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | MD227827
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 2020-00231
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 2025010194
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | MD70045405
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 60461
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 2084E0001X
-----------------------------------------------------
Taxonomy Name | Epilepsy Physician
-----------------------------------------------------
License Number | 60461
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 2084N0600X
-----------------------------------------------------
Taxonomy Name | Clinical Neurophysiology Physician
-----------------------------------------------------
License Number | 60461
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------