Individual
DR. PRABODH MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1324 WOODLAND DRIVE,, SUITE A, ELIZABETHTOWN, KY 42701-2746
(270) 765-5921
(270) 765-4391
Mailing address
1324 WOODLAND DRIVE,, SUITE A, ELIZABETHTOWN, KY 42701-2746
(270) 765-5921
(270) 765-4391
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30758
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64307580
—
KY
Enumeration date
08/12/2005
Last updated
09/15/2016
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