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General NPI Number Information
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NPI Number | 1669155503
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Entity Type | Individual
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Provider Name | MARJAN ASADOLLAHI MD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE STE B101
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City | LEXINGTON
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State | KY
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Zip | 40536-5137
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Country | US
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Telephone | 859-323-5661
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Fax | 859-323-6411
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Provider Business Mailing Address
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Address Line | 740 S LIMESTONE
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | FL083
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | LT000977
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | FL083
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | FL083
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License Number State | KY
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