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NPI Code Detail

MEDICARE: RAVI SHANKAR M.D.

MEDICARE: RAVI SHANKAR M.D.
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
12084P0800XPsychiatry Physician59017KY
22084P0800XPsychiatry Physician2014002057MO
32084P0804XChild & Adolescent Psychiatry Physician2014002057MO
42084P0804XChild & Adolescent Psychiatry Physician59017KY

General Provider Information

NPI Number : 1306070115
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVI SHANKAR M.D.
Provider Business Mailing Address
First Line : PO BOX 843966
Second Line :
City : KANSAS CITY
State : MO
Zip : 64184-3966
Country : US
Telephone Number : 573-884-3300
Fax Number : 573-884-0943
Provider Business Practice Location Address
First Line : 245 FOUNTAIN CT STE 225
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-2794
Country : US
Telephone Number : 859-323-6021
Fax Number : 859-323-1670
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2009
Last Update Date : 07/23/2024

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