Provider Demographics
NPI:1669414090
Name:MAKHNI, PARVEEN B (MD)
Entity type:Individual
Prefix:
First Name:PARVEEN
Middle Name:B
Last Name:MAKHNI
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 1:980 HIGHWAY 28
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3695
Mailing Address - Country:US
Mailing Address - Phone:423-942-3409
Mailing Address - Fax:423-942-3410
Practice Address - Street 1:980 HIGHWAY 28
Practice Address - Street 2:SUITE 101
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3695
Practice Address - Country:US
Practice Address - Phone:423-942-3409
Practice Address - Fax:423-942-3409
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME49671207R00000X
TNME49671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNME49671OtherMEDICAL LICENSE
FL56173Medicare ID - Type Unspecified