Basic Information
| Provider Information | |||||||||
| NPI: | 1003924804 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEHDI AHMADI MURRAY ONCOLOGY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9150 | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420029150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707449600 | ||||||||
| FaxNumber: | 2707448642 | ||||||||
| Practice Location | |||||||||
| Address1: | 204 S 9TH ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420712409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707594199 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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| AuthorizedOfficialLastName: | AHMADI | ||||||||
| AuthorizedOfficialFirstName: | MEHDI | ||||||||
| AuthorizedOfficialMiddleName: | JOON | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR/BUSINESS OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2707594199 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.