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NPI Code Detail

MEDICARE: GRAM RESOURCES, INC

MEDICARE: GRAM RESOURCES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083706246
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRAM RESOURCES, INC
Provider Business Mailing Address
First Line : PO BOX 2028
Second Line :
City : HAZARD
State : KY
Zip : 41702-2028
Country : US
Telephone Number : 606-439-2662
Fax Number : 606-439-2662
Provider Business Practice Location Address
First Line : 1908 N MAIN ST
Second Line :
City : HAZARD
State : KY
Zip : 41701-2505
Country : US
Telephone Number : 606-439-2662
Fax Number : 606-439-2662
Authorized Official
Title or Position : PRESIDENT
Name : DR. ASHOK PATEL
Credential : M.D.
Telephone Number : 606-439-5057
Provider Enumeration Date : 09/28/2006
Last Update Date : 04/01/2011

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