Provider Demographics
NPI:1609943745
Name:MEGHANI MEDICAL, PC
Entity Type:Organization
Organization Name:MEGHANI MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-712-1170
Mailing Address - Street 1:218 HOSPITAL AVE # F
Mailing Address - Street 2:SUITE C
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-2064
Mailing Address - Country:US
Mailing Address - Phone:334-774-5005
Mailing Address - Fax:334-774-5007
Practice Address - Street 1:218 HOSPITAL AVE # F
Practice Address - Street 2:SUITE C
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-2064
Practice Address - Country:US
Practice Address - Phone:334-774-5005
Practice Address - Fax:334-774-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK180Medicare ID - Type UnspecifiedMEDICARE GROUP