| Virtual Consult MD, LLC | |
|
2202 Hwy 41 North Unit E 152 Hendereson KY 42420 | |
| (812) 848-2322 | |
| (812) 727-5469 |
| Full Name | Virtual Consult MD, LLC |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2202 Hwy 41 North, Hendereson, Kentucky |
| Authorized Official Name and Position | Neil Jariwala (OWNER) |
| Authorized Official Contact | 6782000048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virtual Consult MD, LLC 1222 Professional Blvd Evansville IN 47714-8002 Ph: (812) 720-3800 | Virtual Consult MD, LLC 2202 Hwy 41 North Unit E 152 Hendereson KY 42420 Ph: (812) 848-2322 |
| NPI Number | 1174136337 |
|---|---|
| Provider Enumeration Date | 08/27/2020 |
| Last Update Date | 12/20/2023 |
| Certification Date | 12/20/2023 |
| Medicare PECOS PAC ID | 8527486067 |
|---|---|
| Medicare Enrollment ID | O20200915001373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174136337 | NPI | - | NPPES |
| 53374 | Other | KY | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Secondary |
| Provider Name | Neil B. Jariwala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710206545 PECOS PAC ID: 0941425607 Enrollment ID: I20200915001430 |
| Provider Name | Sharon Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669973822 PECOS PAC ID: 7517222110 Enrollment ID: I20240322000231 |