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NPI Code Detail

MEDICARE: DR. PEYMAN ROOHANI MD

MEDICARE: DR. PEYMAN ROOHANI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician13153RLA
2207R00000XInternal Medicine PhysicianMD.131353RLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285632745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEYMAN ROOHANI MD
Provider Business Mailing Address
First Line : 1453 E BERT KOUNS INDUSTRIAL LOOP
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-6800
Country : US
Telephone Number : 318-773-4903
Fax Number : 318-747-9994
Provider Business Practice Location Address
First Line : 1453 E BERT KOUNS INDUSTRIAL LOOP
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-6800
Country : US
Telephone Number : 318-773-4903
Fax Number : 318-747-9994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 10/02/2023

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Directions to “ DR. PEYMAN ROOHANI MD” Practice Location

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