Provider Demographics
NPI:1407882277
Name:ASHOK K NAKHASI
Entity Type:Organization
Organization Name:ASHOK K NAKHASI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:NAKHASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-272-8644
Mailing Address - Street 1:2710 SAINT FRANCIS DR
Mailing Address - Street 2:SUITE # 302
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5619
Mailing Address - Country:US
Mailing Address - Phone:319-272-8644
Mailing Address - Fax:319-272-8637
Practice Address - Street 1:2710 SAINT FRANCIS DR
Practice Address - Street 2:SUITE # 302
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5619
Practice Address - Country:US
Practice Address - Phone:319-272-8644
Practice Address - Fax:319-272-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA227092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA185629OtherBCBS
IA0287904Medicaid
IAA01843Medicare UPIN
IAI5055Medicare ID - Type Unspecified