Provider Demographics
NPI:1518129055
Name:HAKIMAN, HEKMAT (MD)
Entity Type:Individual
Prefix:
First Name:HEKMAT
Middle Name:
Last Name:HAKIMAN
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 1:2995 W ELLIOT RD STE 4
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1670
Mailing Address - Country:US
Mailing Address - Phone:602-844-5157
Mailing Address - Fax:602-844-5257
Practice Address - Street 1:2995 W ELLIOT RD STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1670
Practice Address - Country:US
Practice Address - Phone:602-844-5157
Practice Address - Fax:602-844-5257
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49709208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ944247Medicaid