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General NPI Number Information
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NPI Number | 1972501559
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Entity Type | Organization
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Legal Business Name | CENTER FOR ARTHRITIS & OSTEOPOROSIS
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 584 WESTPORT RD SUITE 101
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2987
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Country | US
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Telephone | 270-769-2535
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Fax | 270-769-9020
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Provider Business Mailing Address
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Address Line | 584 WESTPORT RD SUITE 101
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2987
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Country | US
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Telephone | 270-769-2535
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Fax | 270-769-9020
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DAKSHA P MEHTA
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Credential | MD
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Telephone | 270-769-2535
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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 | 30757
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License Number State | KY
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