Provider Demographics
NPI:1003924804
Name:MEHDI AHMADI MURRAY ONCOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:MEHDI AHMADI MURRAY ONCOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:JOON
Authorized Official - Last Name:AHMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-759-4199
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:204 S 9TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2409
Practice Address - Country:US
Practice Address - Phone:270-759-4199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7215Medicare ID - Type Unspecified