Provider Demographics
NPI:1558696989
Name:RAVI, VIDHYA LAKSHMI (MD)
Entity Type:Individual
Prefix:
First Name:VIDHYA LAKSHMI
Middle Name:
Last Name:RAVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIDHYA LAKSHMI
Other - Middle Name:
Other - Last Name:MURALIDHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:606-330-7835
Mailing Address - Fax:
Practice Address - Street 1:211 FOUNTAIN CT STE 340
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2957
Practice Address - Country:US
Practice Address - Phone:859-263-1280
Practice Address - Fax:859-263-1290
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine