Basic Information
| Provider Information | |||||||||
| NPI: | 1578662912 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOEL | ||||||||
| FirstName: | PARKASH | ||||||||
| MiddleName: | VATI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 SUMMIT RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452372621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139483600 | ||||||||
| FaxNumber: | 5139488631 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 SUMMIT RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452372621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139483600 | ||||||||
| FaxNumber: | 5139488631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 08/31/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 35.038473 | OH | N | Other Service Providers | Specialist | 207R00000X | 35.038473 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0284384 | 05 | OH | MEDICAID | 311072669 | 01 | OH | TAX ID | OTHER |