| Vivekananda Varma Datla, MD, | |
|
2201 Lexington Ave, Ashland, KY 41101-2843 | |
| (606) 408-4000 | |
| (606) 408-6825 |
| Full Name | Vivekananda Varma Datla |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 25 Years |
| Location | 2201 Lexington Ave, Ashland, Kentucky |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154524148 | NPI | - | NPPES |
| 3066524 | Medicaid | OH | |
| 7100129360 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 43412 (Kentucky) | Secondary |
| 208M00000X | Hospitalist | 43412 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| King's Daughters' Medical Center | Ashland, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kings Daughters Medical Specialties Inc | 6103968029 | 355 |
| Entity Name | Kings Daughters Medical Specialties Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710215736 PECOS PAC ID: 6103968029 Enrollment ID: O20100217000538 |
| Mailing Address | Practice Location Address |
|---|---|
| Vivekananda Varma Datla, MD, Po Box 2379, Ashland, KY 41105-2379 Ph: (606) 408-6200 | Vivekananda Varma Datla, MD, 2201 Lexington Ave, Ashland, KY 41101-2843 Ph: (606) 408-4000 |
Michael Banks, Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2201 Lexington Ave, Ashland, KY 41101 Phone: 606-408-4000 | |
Sara Anne Davis, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2201 Lexington Ave, Ashland, KY 41101 Phone: 606-408-4000 Fax: 606-408-6825 | |
Kayla Diann Bailey, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2201 Lexington Ave, Ashland, KY 41101 Phone: 606-408-4000 | |
Joshua Bryant, D.O. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2201 Lexington Ave, Ashland, KY 41101 Phone: 606-408-4000 | |
Emilio Punzal Jr., MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2201 Lexington Ave, Ashland, KY 41101 Phone: 606-408-4000 Fax: 606-408-6625 | |
Dr. Allen T Cochran, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 2201 Lexington Ave, Ashland, KY 41101 Phone: 606-408-4000 |