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Individual

KUNAL BHATIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2005
(601) 815-0434
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2005
(601) 815-0434

Taxonomy

Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
29576
MS
2084N0400X
Neurology Physician
2016013565
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016013565
MISSOURI TEMPORARY LICENSE
MO
Enumeration date
06/29/2016
Last updated
09/02/2022
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