Provider Demographics
NPI:1356382972
Name:KAPOOR, SANGEETA (MD)
Entity type:Individual
Prefix:
First Name:SANGEETA
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6801 DIXIE HWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3913
Mailing Address - Country:US
Mailing Address - Phone:502-479-4433
Mailing Address - Fax:502-451-5949
Practice Address - Street 1:2020 NEWBURG RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1803
Practice Address - Country:US
Practice Address - Phone:502-451-3330
Practice Address - Fax:502-375-1151
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY38469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00147662OtherRR MEDICARE
KY64080211Medicaid
KY64080211Medicaid
KYI04498Medicare UPIN