Provider Demographics
NPI:1366431017
Name:MAHESHWARI, JEWRAJ GOKLANI (MD)
Entity type:Individual
Prefix:
First Name:JEWRAJ
Middle Name:GOKLANI
Last Name:MAHESHWARI
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:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-3445
Mailing Address - Fax:270-688-3344
Practice Address - Street 1:1000 BRECKENRIDGE ST STE 201
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-0876
Practice Address - Country:US
Practice Address - Phone:270-688-3445
Practice Address - Fax:270-688-3344
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36564207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65946162Medicaid
KY00337001Medicare PIN
G82216Medicare UPIN
KY00337Medicare PIN
IN252110Medicare PIN
IN252110BMedicare PIN