Provider Demographics
NPI:1144404104
Name:TIGRANI, KHOSRO (MD)
Entity Type:Individual
Prefix:
First Name:KHOSRO
Middle Name:
Last Name:TIGRANI
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 1:318 LINCOLN HL NW
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-4496
Mailing Address - Country:US
Mailing Address - Phone:217-222-6712
Mailing Address - Fax:
Practice Address - Street 1:318 LINCOLN HL NW
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-4496
Practice Address - Country:US
Practice Address - Phone:217-222-6712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist