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General NPI Number Information
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NPI Number | 1194945956
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Entity Type | Organization
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Legal Business Name | E.W. UNNIKRISHNAN M.D. PSC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 900 SAINT CHRISTOPHER DR SUITE 201
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City | ASHLAND
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State | KY
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Zip | 41101-7090
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Country | US
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Telephone | 606-836-2311
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Fax | 606-836-3616
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Provider Business Mailing Address
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Address Line | 900 ST CHRISTOPHER DR SUITE 201
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City | ASHLAND
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State | KY
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Zip | 41101
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Country | US
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Telephone | 606-836-2311
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Fax | 606-836-3616
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. E.W UNNIKRISHNAN
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Credential | M.D
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Telephone | 606-836-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 19376
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License Number State | KY
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