1659652451 NPI number — AKSHAY GOEL MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659652451 NPI number — AKSHAY GOEL MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

GOEL

Provider First Name:

AKSHAY

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1659652451

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/17/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1249 15TH ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

HUNTINGTON

Provider Business Mailing Address State Name:

WV

Provider Business Mailing Address Postal Code:

25701-3662

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

304-691-8722

Provider Business Mailing Address Fax Number:

304-691-8591

Provider First Line Business Practice Location Address:

2483 HIGHWAY 644

Provider Second Line Business Practice Location Address:

STE 201

Provider Business Practice Location Address City Name:

LOUISA

Provider Business Practice Location Address State Name:

KY

Provider Business Practice Location Address Postal Code:

41230-9242

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

606-638-7399

Provider Business Practice Location Address Fax Number:

606-638-7088

Provider Enumeration Date:

09/07/2011

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207X00000X , with the licence number:  47314 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207X00000X , with the licence number: L.3447R , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207X00000X , with the licence number: MSF1006 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 051120424 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
• Identifier: 132443 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
• Identifier: 132444 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
• Identifier: 04231505 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
• Identifier: Z21049 . This is a "VIVA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
• Identifier: 132442 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
• Identifier: 3810029467 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
• Identifier: 051120423 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
• Identifier: 051120425 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
• Identifier: 7100310630 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".