# BLUEGRASS MEDICAL PRACTITIONERS INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689019440
- **Authorized official:** BAHAR MITTAL MD (PRESIDENT)
- **Authorized official phone:** (859) 757-4353

## Contact information

- **Practice address:** 47 CAVALIER BLVD STE 100, FLORENCE, KY 41042-3970
- **Practice address phone:** (859) 757-4353
- **Practice address fax:** (859) 534-0865
- **Mailing address:** 47 CAVALIER BLVD STE 100, FLORENCE, KY 41042-3970
- **Mailing address phone:** (859) 757-4353
- **Mailing address fax:** (859) 534-0865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 38913 | KY | Yes |

## Other

- **Enumeration date:** 05/07/2013
- **Last updated:** 05/07/2013