Organization
DIGESTIVE & LIVER CLINIC, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOK KANTHAWAR MD (CEO)
(606) 877-1575
Entity
Organization
Contact information
Practice address
1360 W 5TH ST, LONDON, KY 40741-1615
(606) 877-1575
(606) 877-1582
Mailing address
1360 W 5TH ST, LONDON, KY 40741-1615
(606) 877-1575
(606) 877-1582
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
37920
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000654360
ANTHEM
KY
01
—
50008556
PASSPORT ADVANTAGE
KY
01
—
614933100
BLACK LUNG
KY
05
—
7100112810
—
KY
01
—
C23095
CHI
KY
Enumeration date
01/06/2010
Last updated
03/16/2012
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