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NPI Code Detail

MEDICARE: MOKHTAR HACENA MD

MEDICARE: MOKHTAR HACENA 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
1207RA0201XAllergy & Immunology (Internal Medicine) Physician055062GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00332224OTHERGAMEDICARE RAILROAD#

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 : 1861448110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOKHTAR HACENA MD
Provider Business Mailing Address
First Line : 2054 WATSON BLVD
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31093-3634
Country : US
Telephone Number : 478-918-0770
Fax Number : 478-918-0771
Provider Business Practice Location Address
First Line : 2054 WATSON BLVD
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31093-3634
Country : US
Telephone Number : 478-918-0770
Fax Number : 478-918-0771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 07/23/2008

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Directions to “ MOKHTAR HACENA MD” Practice Location

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