Provider Demographics
NPI:1013958909
Name:HASHMI, SHAKEB (MD)
Entity type:Individual
Prefix:DR
First Name:SHAKEB
Middle Name:
Last Name:HASHMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6359 MASSEY MANOR LN W
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-1400
Mailing Address - Country:US
Mailing Address - Phone:214-991-4259
Mailing Address - Fax:870-400-2644
Practice Address - Street 1:200 W TYLER AVE
Practice Address - Street 2:CRITTENDEN REGIONAL HOSPITAL
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4223
Practice Address - Country:US
Practice Address - Phone:870-735-1500
Practice Address - Fax:870-400-2644
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9562207P00000X
ARE-0362207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K247OtherAR BCBS
AR130028001Medicaid
ARG35369Medicare UPIN
AR5K247Medicare PIN