Provider Demographics
NPI:1396763645
Name:HUSSEIN, RAFID J (DO)
Entity type:Individual
Prefix:
First Name:RAFID
Middle Name:J
Last Name:HUSSEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STEAM PLANT RD STE 450
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3079
Mailing Address - Country:US
Mailing Address - Phone:615-822-6716
Mailing Address - Fax:615-328-3709
Practice Address - Street 1:300 STEAM PLANT RD STE 450
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3079
Practice Address - Country:US
Practice Address - Phone:615-822-6716
Practice Address - Fax:615-328-3709
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1009014097207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100635Medicaid
MO1396763645Medicaid
MO1396763645Medicaid
ILK16093Medicare ID - Type Unspecified
ILK16092Medicare ID - Type Unspecified
IL036100635Medicaid