Provider Demographics
NPI:1851788020
Name:BURHANI, FARAH (MD)
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:BURHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 ELLIOTT ST
Mailing Address - Street 2:FAMILY MEDICINE
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-7732
Mailing Address - Country:US
Mailing Address - Phone:318-441-1030
Mailing Address - Fax:318-441-1050
Practice Address - Street 1:821 ELLIOTT ST
Practice Address - Street 2:FAMILY MEDICINE
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-441-1030
Practice Address - Fax:318-441-1050
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310294207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine