Provider Demographics
NPI:1225218167
Name:DIXIT, RAHUL (MD)
Entity type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:DIXIT
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 1:1309 SMYRNA LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1754
Mailing Address - Country:US
Mailing Address - Phone:606-521-8576
Mailing Address - Fax:606-280-7570
Practice Address - Street 1:1 TRILLIUM WAY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-8426
Practice Address - Country:US
Practice Address - Phone:606-521-8576
Practice Address - Fax:606-280-7570
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28238208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64282387Medicaid
KY28238OtherMEDICAL LICENSE
000000187164OtherBLUE CROSS & BLUE SHIELD
BD2847082OtherDEA
KY28238OtherMEDICAL LICENSE
E93995Medicare UPIN