Provider Demographics
NPI:1508805870
Name:K G SAHETYA PSC
Entity Type:Organization
Organization Name:K G SAHETYA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALIDAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:SAHETYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-796-8800
Mailing Address - Street 1:PO BOX 90039
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-9039
Mailing Address - Country:US
Mailing Address - Phone:270-796-8800
Mailing Address - Fax:270-796-9328
Practice Address - Street 1:427 US 31W BYP
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1703
Practice Address - Country:US
Practice Address - Phone:270-796-8800
Practice Address - Fax:270-796-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20980207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000050059OtherANTHEM BC BS
KY64209802Medicaid
KY6600Medicare PIN
KY000000050059OtherANTHEM BC BS