Provider Demographics
NPI:1619110681
Name:VIRSHNI, KINGAL (MD)
Entity Type:Individual
Prefix:
First Name:KINGAL
Middle Name:
Last Name:VIRSHNI
Suffix:
Gender:M
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:231 E CHESTNUT ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-629-7661
Practice Address - Fax:502-629-5309
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY436102085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY203438OtherCSHCS - KCR
KY7472334OtherCIGNA - KCR
KY50030000OtherPASSPORT/PASSPORT ADVANTAGE - KCR
KY7100132010Medicaid
KY000000672818OtherANTHEM - KCR
KY117075OtherSIHO - KCR
IN201008090Medicaid
KY000052153ZOtherHUMANA - KCR
KY117075OtherSIHO - KCR