Provider Demographics
NPI:1366445561
Name:BIKHAZI, GEORGE B (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:B
Last Name:BIKHAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 DANNY THOMAS PLACE, MS 0515
Mailing Address - Street 2:ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3006
Mailing Address - Fax:901-595-3842
Practice Address - Street 1:262 DANNY THOMAS PLACE, MS 0515
Practice Address - Street 2:ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3006
Practice Address - Fax:901-595-3842
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2011-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN35688207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0030325Medicaid
AL009977030Medicaid
AR145681001Medicaid
NC7612967Medicaid
MT0078574Medicaid
IN200361500AMedicaid
ME422400000Medicaid
TN3899656Medicaid
AZ715469Medicaid
MS00125142Medicaid
IA0554261Medicaid
NE100249678-00Medicaid
LA1112135Medicaid
GA181546610AMedicaid
MO209197706Medicaid
MI104823400Medicaid
CO11001577Medicaid
KY64045651Medicaid
NJ0030325Medicaid