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NPI Code Detail

MEDICARE: FAKHRE FAKHRE M.D.

MEDICARE:   FAKHRE  FAKHRE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician11307RLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134186133
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAKHRE FAKHRE M.D.
Provider Business Mailing Address
First Line : 706 ROSS ST
Second Line :
City : OAK GROVE
State : LA
Zip : 71263-9798
Country : US
Telephone Number : 318-428-3237
Fax Number : 318-428-6180
Provider Business Practice Location Address
First Line : 706 ROSS ST
Second Line :
City : OAK GROVE
State : LA
Zip : 71263-9798
Country : US
Telephone Number : 318-428-3237
Fax Number : 318-428-6180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 02/25/2008

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Directions to “ FAKHRE FAKHRE M.D.” Practice Location

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