Dr Doddachallor Matt Shivakumar, MD, is a
Internal Medicine physician based in Hodgenville, Kentucky. Dr Doddachallor Matt Shivakumar is licensed to practice in Kentucky (license number KY20452) and his current practice location is 908 S Lincoln Blvd, Hodgenville, Kentucky. He can be reached at his office (for appointments etc.) via phone at
(270) 358-8650.
NPI number for Dr Doddachallor Matt Shivakumar is 1356311351 and his current mailing address is 908 S Lincoln Blvd, Hodgenville, Kentucky. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356311351.
Physician's Profile
| Full Name | Dr Doddachallor Matt Shivakumar |
|---|
| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 908 S Lincoln Blvd, Hodgenville, Kentucky |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1356311351
- Provider Enumeration Date: 01/24/2006
- Last Update Date: 09/08/2010
Medical Identifiers
Medical identifiers for Dr Doddachallor Matt Shivakumar such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356311351 | NPI | - | NPPES |
| 64204522 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | KY20452 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Doddachallor Matt Shivakumar is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Doddachallor Matt Shivakumar, MD,
908 S Lincoln Blvd,
Hodgenville, KY 42748-1702
Ph: (270) 358-8650 | Dr Doddachallor Matt Shivakumar, MD,
908 S Lincoln Blvd,
Hodgenville, KY 42748-1702
Ph: (270) 358-8650 |
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