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General NPI Number Information
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NPI Number | 1033704358
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Entity Type | Individual
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Provider Name | MOHAMED MAGDY KHODEIRY MD, MSC
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Gender | Male
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 301 E MUHAMMAD ALI BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40202-1511
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Country | US
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Telephone | 502-588-0330
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WASHINGTON PL APT 508
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City | PITTSBURGH
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State | PA
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Zip | 15219-4707
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Country | US
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Telephone | 929-418-9586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | LT000931
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | 32181
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207WX0110X
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Taxonomy Name | Pediatric Ophthalmology and Strabismus Specialist Physician Physician
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License Number | FL072
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | FL072
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License Number State | KY
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