Provider Demographics
NPI:1639434368
Name:HASANIN, MOHSEN (MBCHB)
Entity Type:Individual
Prefix:
First Name:MOHSEN
Middle Name:
Last Name:HASANIN
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HIGHWAY 70 E STE D
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2075
Mailing Address - Country:US
Mailing Address - Phone:615-441-4503
Mailing Address - Fax:615-441-4575
Practice Address - Street 1:113 HIGHWAY 70 E STE D
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2075
Practice Address - Country:US
Practice Address - Phone:615-441-4503
Practice Address - Fax:615-441-4575
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY49037207RG0100X
TN58548207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology