Provider Demographics
NPI:1891169926
Name:NEWBORN & KIDS HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:NEWBORN & KIDS HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:HAKAM
Authorized Official - Last Name:ALNAHHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-277-0173
Mailing Address - Street 1:215 TREUHAFT BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-7361
Mailing Address - Country:US
Mailing Address - Phone:606-277-0173
Mailing Address - Fax:606-277-0045
Practice Address - Street 1:215 TREUHAFT BLVD
Practice Address - Street 2:STE. 8
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7361
Practice Address - Country:US
Practice Address - Phone:606-248-7778
Practice Address - Fax:606-248-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207Q00000X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPENDINGMedicaid