Provider Demographics
NPI:1194868372
Name:RAHUL DIXIT MD PSC
Entity Type:Organization
Organization Name:RAHUL DIXIT MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-699-3380
Mailing Address - Street 1:1309 SMYRNA LANE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513
Mailing Address - Country:US
Mailing Address - Phone:859-224-4815
Mailing Address - Fax:606-523-8719
Practice Address - Street 1:1309 SMYRNA LANE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513
Practice Address - Country:US
Practice Address - Phone:859-699-3380
Practice Address - Fax:606-280-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28238208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000187164OtherBLUE CROSS & BLUE SHIELD
KY28238OtherMEDLIC
KY64282387Medicaid
KY64282387Medicaid
1829901Medicare ID - Type Unspecified
KY28238OtherMEDLIC