Provider Demographics
NPI:1972585883
Name:DESHMUKH, YUSUF KHAN (MD)
Entity type:Individual
Prefix:DR
First Name:YUSUF
Middle Name:KHAN
Last Name:DESHMUKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1107 WOODLAND DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2789
Mailing Address - Country:US
Mailing Address - Phone:270-769-6665
Mailing Address - Fax:270-769-0322
Practice Address - Street 1:1107 WOODLAND DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2789
Practice Address - Country:US
Practice Address - Phone:270-769-6665
Practice Address - Fax:270-769-0322
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21252207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1050025OtherPASSPORT
KY64212525Medicaid
KY1050025OtherPASSPORT
KYC74690Medicare UPIN