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NPI Code Detail

MEDICARE: DR. GHASSAN SHAKHASHIRO M.D.

MEDICARE: DR. GHASSAN SHAKHASHIRO M.D.
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
1208M00000XHospitalist Physician35630KY
2207R00000XInternal Medicine Physician35630KY
3207Q00000XFamily Medicine Physician35630KY

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 : 1871567396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GHASSAN SHAKHASHIRO M.D.
Provider Business Mailing Address
First Line : 1 SAINT JOSEPH DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3742
Country : US
Telephone Number : 859-313-2963
Fax Number : 859-313-3541
Provider Business Practice Location Address
First Line : 1 SAINT JOSEPH DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-3742
Country : US
Telephone Number : 859-313-2963
Fax Number : 859-313-3541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 05/18/2026

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