Ketan C. Vyas, M.D., LLC

Organization Active NPI Internal Medicine Physician · Grayville, IL

NPI 1700920097 · NPPES record last updated Jul 15, 2008

Key facts

NPI
1700920097
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
036091476 (IL)
Legal business name
KETAN C. VYAS, M.D., LLC
Practice address
610 N Court St
Grayville, IL 62844-1002
Phone
(618) 375-7101
Fax
(618) 375-7183
NPI assigned
Feb 19, 2007
Organization subpart
No

Authorized official

Name
Dr. Ketan C Vyas, M.D.
Title
President
Phone
(618) 375-7101

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X 036091476 IL Yes

Addresses

Primary practice location

610 N Court St
Grayville, IL 62844-1002

Mailing address

610 N Court St
Grayville, IL 62844-1002
Phone (618) 375-7101

Other providers in Grayville, IL

All providers in Grayville, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.