Basic Information
Provider Information
NPI: 1346479235
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LODHI
FirstName: HAMZA
MiddleName: A
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 405827
Address2:  
City: ATLANTA
State: GA
PostalCode: 30384
CountryCode: US
TelephoneNumber: 9012274068
FaxNumber: 9012274051
Practice Location
Address1: 7601 SOUTHCREST PARKWAY
Address2:  
City: SOUTHAVEN
State: MS
PostalCode: 38671
CountryCode: US
TelephoneNumber: 6627722488
FaxNumber: 6627723102
Other Information
ProviderEnumerationDate: 07/13/2009
LastUpdateDate: 11/08/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301095165MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X22146MSY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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