Provider Demographics
NPI:1043322175
Name:PATEL, USHMA (MD)
Entity Type:Individual
Prefix:MRS
First Name:USHMA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1378
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1378
Mailing Address - Country:US
Mailing Address - Phone:606-408-7246
Mailing Address - Fax:606-408-7230
Practice Address - Street 1:617 23RD STREET
Practice Address - Street 2:MEDICAL PLAZA A SUITE 8B
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2845
Practice Address - Country:US
Practice Address - Phone:606-408-7246
Practice Address - Fax:606-408-7230
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39645208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64109796Medicaid
I38593Medicare UPIN
KY64109796Medicaid