Provider Demographics
NPI:1093866303
Name:HOKAN, KAMAL (MD)
Entity Type:Individual
Prefix:
First Name:KAMAL
Middle Name:
Last Name:HOKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 OHIO AVE
Mailing Address - Street 2:STE 2C
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-6217
Mailing Address - Country:US
Mailing Address - Phone:662-627-2544
Mailing Address - Fax:662-627-2052
Practice Address - Street 1:785 OHIO AVE
Practice Address - Street 2:STE 2C
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-6217
Practice Address - Country:US
Practice Address - Phone:662-627-2544
Practice Address - Fax:662-627-2052
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010721332084N0400X
MS229822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS22982OtherMS LICENSE
MI201335550OtherTAX ID
MIKH072133OtherSTATE LICENSE
MS361911ZH43Medicare PIN