Healthcare Provider Details

I. General information

NPI: 1003924804
Provider Name (Legal Business Name): MEHDI AHMADI MURRAY ONCOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S 9TH ST SUITE A
MURRAY KY
42071-2409
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 270-759-4199
  • Fax:
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MEHDI JOON AHMADI
Title or Position: DOCTOR/BUSINESS OWNER
Credential: M.D.
Phone: 270-759-4199