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NPI Code Detail

MEDICARE: DR. AVASHKAR WOOMPATH DO

MEDICARE: DR. AVASHKAR WOOMPATH DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207QG0300XGeriatric Medicine (Family Medicine) Physician05478KY

General Provider Information

NPI Number : 1538726112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AVASHKAR WOOMPATH DO
Provider Business Mailing Address
First Line : 85 N GRAND AVE
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-4027
Country : US
Telephone Number : 859-912-7211
Fax Number : 859-655-6674
Provider Business Practice Location Address
First Line : 85 N GRAND AVE
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-4027
Country : US
Telephone Number : 859-912-7211
Fax Number : 859-655-6674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2019
Last Update Date : 08/01/2023

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Directions to “ DR. AVASHKAR WOOMPATH DO” Practice Location

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