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General NPI Number Information
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NPI Number | 1144402629
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Entity Type | Organization
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Legal Business Name | GHORI LLC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 1369 W. MAIN ST. SUITE 2
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City | DOTHAN
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State | AL
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Zip | 36301
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Country | US
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Telephone | 334-792-8679
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Fax | 877-361-4549
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Provider Business Mailing Address
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Address Line | 1369 W. MAIN ST. SUITE 2
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City | DOTHAN
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State | AL
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Zip | 36301
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Country | US
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Telephone | 334-792-8679
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Fax | 877-361-4549
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHER M GHORI
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Credential | M.D.
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Telephone | 334-792-8679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 00023730
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License Number State | AL
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