Healthcare Provider Details

I. General information

NPI: 1659128171
Provider Name (Legal Business Name): VINAY KHARE MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

802 LAKELAND DR APT 505
JACKSON MS
39216-4654
US

V. Phone/Fax

Practice location:
  • Phone: 913-442-1452
  • Fax:
Mailing address:
  • Phone: 913-442-1452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: