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NPI Code Detail

MEDICARE: ABDUL-RAHMAN MOHAMMAD JESRI MD

MEDICARE: ABDUL-RAHMAN MOHAMMAD JESRI MD
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 Physician94-12723KS

General Provider Information

NPI Number : 1639971625
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABDUL-RAHMAN MOHAMMAD JESRI MD
Provider Business Mailing Address
First Line : 1010 N KANSAS ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-3124
Country : US
Telephone Number : 316-293-2665
Fax Number :
Provider Business Practice Location Address
First Line : 1010 N KANSAS ST
Second Line :
City : WICHITA
State : KS
Zip : 67214-3124
Country : US
Telephone Number : 316-293-2665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2025
Last Update Date : 06/02/2026

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