Provider Demographics
NPI:1366430993
Name:YOGESH, KUMAR P (MD)
Entity type:Individual
Prefix:DR
First Name:KUMAR
Middle Name:P
Last Name:YOGESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38225-1467
Mailing Address - Country:US
Mailing Address - Phone:731-364-3196
Mailing Address - Fax:731-364-5359
Practice Address - Street 1:130 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:TN
Practice Address - Zip Code:38225-1467
Practice Address - Country:US
Practice Address - Phone:731-364-3196
Practice Address - Fax:731-364-5359
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21214207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3065960Medicaid
TN3065960Medicaid
TNE62916Medicare UPIN