Provider Demographics
NPI:1770783995
Name:DHOLAKIA AND ASSOCIATES, PSC
Entity type:Organization
Organization Name:DHOLAKIA AND ASSOCIATES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:V
Authorized Official - Last Name:DHOLAKIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-248-0507
Mailing Address - Street 1:2315 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2834
Mailing Address - Country:US
Mailing Address - Phone:606-248-0508
Mailing Address - Fax:606-248-2030
Practice Address - Street 1:2315 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2834
Practice Address - Country:US
Practice Address - Phone:606-248-0507
Practice Address - Fax:606-248-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23755208800000X
KY23759208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65929713Medicaid
A97508Medicare UPIN
KY65929713Medicaid