Provider Demographics
NPI:1215005616
Name:MEGHANI MEDICAL, PC
Entity Type:Organization
Organization Name:MEGHANI MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-712-1170
Mailing Address - Street 1:1865 HONEYSUCKLE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-4286
Mailing Address - Country:US
Mailing Address - Phone:334-699-2270
Mailing Address - Fax:
Practice Address - Street 1:1865 HONEYSUCKLE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-4286
Practice Address - Country:US
Practice Address - Phone:334-699-2270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK585Medicare ID - Type UnspecifiedMEDICARE GROUP