Provider Demographics
NPI:1750644407
Name:BHALODI, AMUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:AMUL
Middle Name:A
Last Name:BHALODI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:800 ROSE STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-6679
Mailing Address - Fax:859-323-1944
Practice Address - Street 1:740 SOUTH LIMESTONE
Practice Address - Street 2:SUITE B200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-3533
Practice Address - Fax:859-257-6024
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY390200000X
KYTP 170208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYTP170OtherKY MEDICAL LICENSE