Individual
VIJAY MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 737-1212
Mailing address
504 AINTREE AVE, HOLLY SPRINGS, NC 27540-4987
(317) 379-6341
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
01056824
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
55613
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200406490
—
IN
Enumeration date
09/13/2006
Last updated
04/24/2025
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