Provider Demographics
NPI:1023243144
Name:YALAMANCHI, SWATI (MD)
Entity type:Individual
Prefix:DR
First Name:SWATI
Middle Name:
Last Name:YALAMANCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40702-1325
Mailing Address - Country:US
Mailing Address - Phone:606-526-8131
Mailing Address - Fax:606-528-8661
Practice Address - Street 1:1 TRILLIUM WAY
Practice Address - Street 2:BAPTIST HEALTH CANCER CENTER
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-8727
Practice Address - Country:US
Practice Address - Phone:606-523-1934
Practice Address - Fax:606-523-1982
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45450207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP01522982OtherRR MEDICARE
KY7100316060Medicaid
KYP01522982OtherRR MEDICARE