Provider Demographics
NPI:1275516965
Name:SAXENA, ANGELA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SAXENA
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 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:270-864-1472
Mailing Address - Fax:270-864-1693
Practice Address - Street 1:279 KINGS DAUGHTERS DR
Practice Address - Street 2:ST 301
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6561
Practice Address - Country:US
Practice Address - Phone:502-227-2229
Practice Address - Fax:502-227-1114
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39339207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64104672Medicaid
KYI33238Medicare UPIN
KY64104672Medicaid
KYK080400Medicare PIN
KY0612808Medicare PIN