Provider Demographics
NPI:1962666594
Name:PALANI, RAJANEESHANKAR (MBBS, MD, DNB)
Entity Type:Individual
Prefix:
First Name:RAJANEESHANKAR
Middle Name:
Last Name:PALANI
Suffix:
Gender:M
Credentials:MBBS, MD, DNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:231 E CHESTNUT ST
Practice Address - Street 2:RADIOLOGY DEPT
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-629-7661
Practice Address - Fax:502-629-5309
Is Sole Proprietor?:No
Enumeration Date:2008-07-13
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY436062085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000670618OtherANTHEM - KCR
KY000052153VOtherHUMANA - KCR
KY203438OtherCSHCS - KCR
KY9870824OtherCIGNA - KCR
KY116720OtherSIHO - KCR
KY7100124130Medicaid
KY50029554OtherPASSPORT/PASSPORT ADVANTAGE - KCR
KY116720OtherSIHO - KCR