Individual
DR. SURYACHANDRA S PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 WEST US 60, IRVINGTON, KY 40146
(270) 547-7161
(270) 547-7163
Mailing address
PO BOX 147, IRVINGTON, KY 40146-0147
(270) 547-7161
(270) 547-7163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20984
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047259
ANTHEM BCBS
KY
01
—
1049345
PASSPORT HEALTH PLAN
KY
01
—
2432480000
PASSPORT ADVANTAGE
KY
05
—
64209844
—
KY
01
—
P00010531
RAILROAD MEDICARE
KY
Enumeration date
02/15/2007
Last updated
01/02/2020
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