Provider Demographics
NPI:1972501559
Name:CENTER FOR ARTHRITIS & OSTEOPOROSIS
Entity Type:Organization
Organization Name:CENTER FOR ARTHRITIS & OSTEOPOROSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAKSHA
Authorized Official - Middle Name:P
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-769-2535
Mailing Address - Street 1:584 WESTPORT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2987
Mailing Address - Country:US
Mailing Address - Phone:270-769-2535
Mailing Address - Fax:270-769-9020
Practice Address - Street 1:584 WESTPORT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2987
Practice Address - Country:US
Practice Address - Phone:270-769-2535
Practice Address - Fax:270-769-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30757207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY69535843Medicaid
KY69535843Medicaid