MEDICARE: AMIR NESHATFAR

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
1	2084N0400X	Neurology Physician	2023002912	MO

General Provider Information

NPI Number	:	1821550831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIR NESHATFAR

Provider Business Mailing Address
First Line	:	PO BOX 802843
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64180-2843
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 KINGS HWY
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-4228
Country	:	US
Telephone Number	:	318-626-0434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	12/10/2025

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Directions to “ AMIR NESHATFAR ” Practice Location

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