Provider Demographics
NPI:1942329438
Name:SHARMA, MUKUT (MD)
Entity Type:Individual
Prefix:DR
First Name:MUKUT
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 2-I
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9466
Mailing Address - Country:US
Mailing Address - Phone:606-487-0888
Mailing Address - Fax:606-487-0890
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:STE 2I
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9422
Practice Address - Country:US
Practice Address - Phone:606-487-0888
Practice Address - Fax:606-487-0890
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY34715207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64347164Medicaid