Provider Demographics
NPI:1700974797
Name:YALKUT, DENIS A (MD)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:A
Last Name:YALKUT
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 1:2161 LEXINGTON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7952
Mailing Address - Country:US
Mailing Address - Phone:859-624-2442
Mailing Address - Fax:859-624-2443
Practice Address - Street 1:2161 LEXINGTON RD STE 2
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7952
Practice Address - Country:US
Practice Address - Phone:859-624-2442
Practice Address - Fax:859-624-2443
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37296208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64050131Medicaid
KYG69251Medicare UPIN
KY0383406Medicare PIN
KYP00415708Medicare PIN
KYP400036688Medicare PIN
KYP00920501Medicare PIN