Provider Demographics
NPI:1932259827
Name:AGARWAL, AMAL K (DO)
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:K
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE STREET
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-3558
Mailing Address - Country:US
Mailing Address - Phone:859-323-5908
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST RM M53
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-6511
Practice Address - Country:US
Practice Address - Phone:859-323-5908
Practice Address - Fax:859-323-8056
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO1485207P00000X
IL036-122659207P00000X
KY04041207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine