Provider Demographics
NPI:1215943428
Name:VORA, CHINTAMANI RAJU (MD)
Entity type:Individual
Prefix:MRS
First Name:CHINTAMANI
Middle Name:RAJU
Last Name:VORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1240
Mailing Address - Street 2:315 HOSPITAL DRIVE STE 4
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906
Mailing Address - Country:US
Mailing Address - Phone:606-546-4411
Mailing Address - Fax:606-545-9326
Practice Address - Street 1:315 HOSPITAL DRIVE
Practice Address - Street 2:STE 4
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906
Practice Address - Country:US
Practice Address - Phone:606-546-4411
Practice Address - Fax:606-545-9326
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY196482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000039579OtherBCBS
KY64196488Medicaid
KY000000039579OtherBCBS
C69526Medicare UPIN