Provider Demographics
NPI:1467514505
Name:OURANOS, HOSSEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOSSEIN
Middle Name:
Last Name:OURANOS
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 1:319 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2963
Mailing Address - Country:US
Mailing Address - Phone:270-869-9888
Mailing Address - Fax:270-869-9129
Practice Address - Street 1:319 8TH ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2963
Practice Address - Country:US
Practice Address - Phone:270-869-9888
Practice Address - Fax:270-869-9129
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC45942Medicare UPIN