Provider Demographics
NPI:1861647992
Name:JIBRINI MD ASSOCIATES PLLC
Entity Type:Organization
Organization Name:JIBRINI MD ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MHAMAD
Authorized Official - Middle Name:B
Authorized Official - Last Name:JIBRINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-459-2424
Mailing Address - Street 1:PO BOX 636267
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:859-459-5454
Mailing Address - Fax:859-459-2494
Practice Address - Street 1:7210 TURFWAY RD
Practice Address - Street 2:STE C
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5117
Practice Address - Country:US
Practice Address - Phone:859-459-2424
Practice Address - Fax:859-459-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2915019Medicaid
DO6031OtherRR MEDICARE
IN200926640AMedicaid
KY00805Medicare PIN
OH2915019Medicaid