Provider Demographics
NPI:1992753727
Name:VORA, KISHOR N (MD)
Entity type:Individual
Prefix:
First Name:KISHOR
Middle Name:N
Last Name:VORA
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 1:1200 BRECKENRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1090
Mailing Address - Country:US
Mailing Address - Phone:270-684-0028
Mailing Address - Fax:270-685-8233
Practice Address - Street 1:1200 BRECKENRIDGE ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1090
Practice Address - Country:US
Practice Address - Phone:270-683-8672
Practice Address - Fax:270-685-8223
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28753207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64287535Medicaid
KY0665301Medicare PIN
KY0665301Medicare ID - Type Unspecified
KY64287535Medicaid