Provider Demographics
NPI:1649490418
Name:KALE, SANTOSH SUDHIR (MD)
Entity type:Individual
Prefix:DR
First Name:SANTOSH
Middle Name:SUDHIR
Last Name:KALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 W TYLER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-4257
Mailing Address - Country:US
Mailing Address - Phone:901-830-6247
Mailing Address - Fax:
Practice Address - Street 1:228 W TYLER AVE STE 200
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4257
Practice Address - Country:US
Practice Address - Phone:901-830-6247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2146207R00000X, 208M00000X
ARE-6712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist