Provider Demographics
NPI:1033131594
Name:GEOGRAPHIC MEDICINE SERVICES
Entity Type:Organization
Organization Name:GEOGRAPHIC MEDICINE SERVICES
Other - Org Name:KHALED A RIKABI, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIKABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-594-6484
Mailing Address - Street 1:PO BOX 4024
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535-4024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 DEBUYS RD.
Practice Address - Street 2:215
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531
Practice Address - Country:US
Practice Address - Phone:228-594-6484
Practice Address - Fax:228-594-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15692207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC02869Medicare ID - Type UnspecifiedMEDICARE GROUP