Provider Demographics
NPI:1114961596
Name:MEHTA, ASHOK K (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:K
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 ADAMS LANE, STE. 13
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37076-8203
Mailing Address - Country:US
Mailing Address - Phone:615-288-4087
Mailing Address - Fax:615-553-4250
Practice Address - Street 1:151 ADAMS LN
Practice Address - Street 2:SUITE 13
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3598
Practice Address - Country:US
Practice Address - Phone:615-288-4087
Practice Address - Fax:615-553-4250
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN37260207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3883277Medicaid
TN3883277Medicaid