Provider Demographics
NPI:1336213925
Name:VISHAL GOEL PSC
Entity Type:Organization
Organization Name:VISHAL GOEL PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-626-4797
Mailing Address - Street 1:PO BOX 1477
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40476-1477
Mailing Address - Country:US
Mailing Address - Phone:859-626-4797
Mailing Address - Fax:859-626-0519
Practice Address - Street 1:789 EASTERN BYP
Practice Address - Street 2:SUITE 17
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2415
Practice Address - Country:US
Practice Address - Phone:859-626-4797
Practice Address - Fax:859-626-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY34522207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Not Answered207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0007304196OtherAETNA
KY1188578OtherCHA
KY64028095Medicaid
KY000000328758OtherANTHEM BLUE CROSS & BLUE
KYH32765OtherBLUE GRASS FAMILY HEALTH
KY65941213Medicaid
KY65941213Medicaid
KY000000328758OtherANTHEM BLUE CROSS & BLUE
KY=========OtherHUMANA
KY65941213Medicaid