Provider Demographics
NPI:1689068561
Name:THAKKAR, PRATIBHA SAHIL (MD, MPH)
Entity Type:Individual
Prefix:
First Name:PRATIBHA
Middle Name:SAHIL
Last Name:THAKKAR
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:PRATIBHA
Other - Middle Name:S
Other - Last Name:AGARWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:MN-140
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-6768
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:4TH FL
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-562-1085
Practice Address - Fax:859-257-5152
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY512002080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine