Individual
MOHAN K. RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOSPITAL DR, MADISONVILLE, KY 42431-1658
(270) 326-4800
(270) 326-4820
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
21551
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044265
BCBS PROVIDER NUMBER
—
01
—
21551
LICENSE
KY
05
—
64215510
—
KY
Enumeration date
09/17/2006
Last updated
12/08/2020
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