MEDICARE: OWENSBORO PSYCHIATRIC GROUP PLLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1891537510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OWENSBORO PSYCHIATRIC GROUP PLLC

Provider Business Mailing Address
First Line	:	PO BOX 3276
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47731-3276
Country	:	US
Telephone Number	:	812-473-0181
Fax Number	:	812-492-6498

Provider Business Practice Location Address
First Line	:	5000 BACK SQUARE DR STE C200
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-7411
Country	:	US
Telephone Number	:	270-240-9200
Fax Number	:	812-492-6349

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. RHINE N HEJRAN
Credential	:	MD
Telephone Number	:	818-451-5869

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	01/16/2025

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