Provider Demographics
NPI:1467547521
Name:DUBLIN HEMATOLOGY ONCOLOGY CARE, PC
Entity Type:Organization
Organization Name:DUBLIN HEMATOLOGY ONCOLOGY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FARID
Authorized Official - Middle Name:U
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-275-1111
Mailing Address - Street 1:207 FAIRVIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2550
Mailing Address - Country:US
Mailing Address - Phone:478-275-1111
Mailing Address - Fax:478-275-1191
Practice Address - Street 1:207 FAIRVIEW PARK DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2550
Practice Address - Country:US
Practice Address - Phone:478-275-1111
Practice Address - Fax:478-275-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA35737174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00530857YMedicaid
GA010615OtherSTATE HEALTH BENEFIT
GAP00171973OtherRAILROAD MEDICARE
GA010615OtherBCGSGA
GA5053830001OtherDMERC
GA324423OtherWELLCARE
GA83BBBRFOtherMEDICARE
GAGRP4933OtherMEDICARE GROUP NUMBER
GA=========OtherALL OTHER CARRIERS
GA324423OtherWELLCARE
GAE96683Medicare UPIN