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General NPI Number Information
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NPI Number | 1770734956
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Entity Type | Organization
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Legal Business Name | RAVINDER S. BHAGRATH M.D. PSC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 255 CHURCH ST SUITE 203
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City | PIKEVILLE
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State | KY
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Zip | 41501-3476
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Country | US
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Telephone | 606-432-9456
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Fax | 606-432-2140
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Provider Business Mailing Address
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Address Line | 255 CHURCH ST SUITE 203
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City | PIKEVILLE
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State | KY
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Zip | 41501-3476
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Country | US
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Telephone | 606-432-9456
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Fax | 606-432-2140
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Authorized Official
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Title or Position | OWNER
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Name | RAVINDER SINGH BHAGRATH
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Credential | M.D.
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Telephone | 606-432-9456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | KY
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