1740366459 NPI number — DR. RATHI NARAYAN M.D.

Table of content: DR. RATHI NARAYAN M.D. (NPI 1740366459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740366459 NPI number — DR. RATHI NARAYAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NARAYAN
Provider First Name:
RATHI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
R
Provider Other First Name:
RATHI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740366459
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
135 W RAVINE RD
Provider Second Line Business Mailing Address:
STE 3A
Provider Business Mailing Address City Name:
KINGSPORT
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37660-3847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-246-6777
Provider Business Mailing Address Fax Number:
423-246-6777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 W RAVINE RD
Provider Second Line Business Practice Location Address:
STE 3A
Provider Business Practice Location Address City Name:
KINGSPORT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37660-3847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-246-6777
Provider Business Practice Location Address Fax Number:
423-246-6777
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  21490 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: TN0121 . This is a "UNITED HEALTHCARE RIVER V" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3700033 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6407869400 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004145033 . This is a "BCBS OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 296269 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010416485 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00419337 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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