Provider Demographics
NPI:1669479911
Name:SHETH, PARESH V (MD)
Entity Type:Individual
Prefix:DR
First Name:PARESH
Middle Name:V
Last Name:SHETH
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 551
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-0551
Mailing Address - Country:US
Mailing Address - Phone:270-885-5003
Mailing Address - Fax:270-885-5826
Practice Address - Street 1:1721 CANTON ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1925
Practice Address - Country:US
Practice Address - Phone:270-885-5003
Practice Address - Fax:270-885-5826
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY367902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64052913Medicaid
KY64052913Medicaid
KY0718201Medicare ID - Type Unspecified