Vivekananda Varma Datla
Family Doctor - Adult Medicine
2201 Lexington Ave
Ashland
, Kentucky 41101-2843
Vivekananda Varma Datla
Family Doctor - Adult Medicine
2201 Lexington Ave
Ashland
, Kentucky 41101-2843
(606) 408-6612
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Vivekananda Varma Datla
- Po Box 2379
- Ashland, KY
- Zip : 41105-2379
- Fax : (606) 408-6612
- Phone : (606) 408-6200
Second Address
- Vivekananda Varma Datla
- 2201 Lexington Ave
- Ashland, KY
- Zip : 41101-2843
- Fax : (606) 408-6825
- Phone : (606) 408-4000
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207QA0505X | Family Doctor - Adult Medicine | 43412 | KY |
National Provider Identifier
| NPI | 1154524148 |
|---|---|
| Provider Name | Vivekananda Varma Datla |
| First Address | Ashland, KY 41105-2379 |
| Second Address | Ashland, KY 41101-2843 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2007 |
| Last Update Date | 08/06/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3066524 | (05) | OH |
| 7100129360 | (05) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.