Healthcare Provider Details

I. General information

NPI: 1790137818
Provider Name (Legal Business Name): NAGHMEHOSSADAT ESHGHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-2344
US

IV. Provider business mailing address

2600 W INA RD APT 263
TUCSON AZ
85741-2344
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2222
  • Fax: 859-323-5090
Mailing address:
  • Phone: 520-626-3587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberE-15160
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number54003
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: