Organization
PRAKASH SHAH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAKASH N SHAH M.D. (PHYSICIAN)
(270) 887-9066
Entity
Organization
Contact information
Practice address
1724 KENTON ST, SUITE 1-D, HOPKINSVILLE, KY 42240-1981
(270) 887-9066
(270) 887-9199
Mailing address
1724 KENTON ST, SUITE 1-D, HOPKINSVILLE, KY 42240-1981
(270) 887-9066
(270) 887-9199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31011
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050781
ANTHEM
KY
01
—
110090936
MEDICARE RAILROAD
KY
05
—
64310113
—
KY
Enumeration date
11/14/2007
Last updated
05/21/2015
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