Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 47271 | KY |
N | 111NI0900X | Internist | 47271 | KY |
Y | 207RH0003X | Hematology & Oncology | 47271 | KY |
N | 207RX0202X | Medical Oncology | 47271 | KY |
NPI | 1164782991 |
---|---|
Provider Name | Yashpal Bhanuprasad Modi |
First Address | Glasgow, KY 42141-1300 |
Second Address | Glasgow, KY 42141-1300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2012 |
Last Update Date | 12/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100311690 | (05) | KY |