Provider Demographics
NPI:1841267846
Name:ARCOT, KISHORE KUMAR (MD)
Entity type:Individual
Prefix:
First Name:KISHORE
Middle Name:KUMAR
Last Name:ARCOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2153 DEPT 51051
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35287-9306
Mailing Address - Country:US
Mailing Address - Phone:901-767-6765
Mailing Address - Fax:901-767-9639
Practice Address - Street 1:6005 PARK AVE
Practice Address - Street 2:SUITE 225B
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5202
Practice Address - Country:US
Practice Address - Phone:901-767-6765
Practice Address - Fax:901-767-9639
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35705207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4086928OtherBLUE SHIELD
TN3725618Medicaid
TN3870729Medicare PIN
TN3725618Medicare PIN
TN3725618Medicaid