Healthcare Provider Details

I. General information

NPI: 1346479235
Provider Name (Legal Business Name): HAMZA A LODHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 SOUTHCREST PARKWAY
SOUTHAVEN MS
38671
US

IV. Provider business mailing address

445 CHARLES H DIMMOCK PKWY STE 100
COLONIAL HEIGHTS VA
23834-2990
US

V. Phone/Fax

Practice location:
  • Phone: 662-772-2488
  • Fax: 662-772-3102
Mailing address:
  • Phone: 804-520-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.148259
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101279818
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101279818
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301095165
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number22146
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: