Provider Demographics
NPI:1497733257
Name:BHATT, PALLAVI K (MD)
Entity Type:Individual
Prefix:
First Name:PALLAVI
Middle Name:K
Last Name:BHATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PALLAVI
Other - Middle Name:BHALCHANDRA
Other - Last Name:JANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:PO BOX 3366
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3366
Mailing Address - Country:US
Mailing Address - Phone:812-450-2240
Mailing Address - Fax:812-450-2710
Practice Address - Street 1:600 MARY ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47747-0001
Practice Address - Country:US
Practice Address - Phone:812-450-2240
Practice Address - Fax:812-450-2710
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027643A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64753130Medicaid
IN100254110Medicaid
C25936Medicare UPIN
KY64753130Medicaid
IN234380AMedicare PIN
IN000000207354OtherBLUE CROSS
C25936Medicare UPIN
IN000000185801OtherBCBS PIN - DEACONESS
KY64753130Medicaid