Provider Demographics
NPI:1821435629
Name:RAFIK KASHLAN MD PC
Entity Type:Organization
Organization Name:RAFIK KASHLAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFIK
Authorized Official - Middle Name:B
Authorized Official - Last Name:KASHLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-472-0472
Mailing Address - Street 1:242 ARROWHEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-1106
Mailing Address - Country:US
Mailing Address - Phone:770-472-0472
Mailing Address - Fax:770-472-9970
Practice Address - Street 1:242 ARROWHEAD BLVD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1106
Practice Address - Country:US
Practice Address - Phone:770-472-0472
Practice Address - Fax:770-472-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty