Basic Information
Provider Information
NPI: 1346475266
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAZ
FirstName: KISHWAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3407
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477333407
CountryCode: US
TelephoneNumber: 8124502240
FaxNumber: 8124502710
Practice Location
Address1: 600 MARY ST
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477101674
CountryCode: US
TelephoneNumber: 8124502240
FaxNumber: 8124502710
Other Information
ProviderEnumerationDate: 05/21/2009
LastUpdateDate: 01/27/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X01074444AINY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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