Provider Demographics
NPI:1306868963
Name:KOTHEGAL, HARI P (MD)
Entity type:Individual
Prefix:DR
First Name:HARI
Middle Name:P
Last Name:KOTHEGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 JOSEPH E SANKER BLVD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-1979
Mailing Address - Country:US
Mailing Address - Phone:513-841-7400
Mailing Address - Fax:513-841-7402
Practice Address - Street 1:4420 AICHOLTZ RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1761
Practice Address - Country:US
Practice Address - Phone:513-732-6200
Practice Address - Fax:513-732-8706
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.049808208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D47526Medicare UPIN
OHKO0890914Medicare ID - Type Unspecified