MEDICARE: DR. USHA PATIL 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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	18139	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1376597195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USHA PATIL M.D.

Provider Business Mailing Address
First Line	:	290 BIG RUN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2903
Country	:	US
Telephone Number	:	859-278-9513
Fax Number	:	859-277-6063

Provider Business Practice Location Address
First Line	:	1460 CUMBERLAND FALLS HWY
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40701-2721
Country	:	US
Telephone Number	:	606-528-1259
Fax Number	:	606-528-4147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	05/15/2014

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