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General NPI Number Information
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NPI Number | 1245488659
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Entity Type | Individual
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Provider Name | HANI A BLEIBEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 910 WALLACE AVE
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City | LEITCHFIELD
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State | KY
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Zip | 42754-2414
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Country | US
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Telephone | 270-259-9316
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Fax | 270-230-0293
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Provider Business Mailing Address
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Address Line | 908 WALLACE AVE
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1479
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Country | US
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Telephone | 270-259-9316
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Fax | 270-230-0293
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301093284
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20716
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 20716
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 44934
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 44934
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 44934
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License Number State | KY
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