Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 21933 | KY |
N | 207QA0505X | Family Doctor - Adult Medicine | 21933 | KY |
NPI | 1043303845 |
---|---|
Provider Name | Dr. Namita R Gopal |
First Address | Paducah, KY 42002-9150 |
Second Address | Owensboro, KY 42301-0372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 26/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64219330 | (05) | KY |
C75637 | (02) | KY |