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Individual

ROY VARGHESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
130 KATE IRELAND DR, HYDEN, KY 41749
(606) 672-2901
(606) 672-3626
Mailing address
130 KATE IRELAND DR, HYDEN, KY 41749
(606) 672-2901
(606) 672-3626

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18866
KY
207RI0200X
Infectious Disease Physician
18866
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000051979
BLUE CROSS BLUE SHIELD
KY
01
020082000
DEPARTMENT OF LABOR
KY
01
110172171
RAILROAD MEDICARE
KY
01
1114590
PASSPORT
KY
01
1532292
UMWA/FUNDS
KY
01
164134000
FEDERAL WORKERS COMP
KY
05
64188667
KY
Enumeration date
01/25/2006
Last updated
05/27/2008
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