Provider Demographics
NPI:1760542096
Name:NARAYAN, P I (MD)
Entity Type:Individual
Prefix:MR
First Name:P I
Middle Name:
Last Name:NARAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:PARAMESWARA
Other - Middle Name:I
Other - Last Name:NARAYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE #1P
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9466
Mailing Address - Country:US
Mailing Address - Phone:606-439-6644
Mailing Address - Fax:606-439-0213
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:SUITE #1P
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9466
Practice Address - Country:US
Practice Address - Phone:606-439-6644
Practice Address - Fax:606-439-0213
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY244402085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64244403Medicaid
KY64244403Medicaid
KY1478801Medicare ID - Type Unspecified