Basic Information
| Provider Information | |||||||||
| NPI: | 1629034079 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAZI | ||||||||
| FirstName: | RAHIL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1707 WATSON BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WARNER ROBINS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310933606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4789298030 | ||||||||
| FaxNumber: | 4789298095 | ||||||||
| Practice Location | |||||||||
| Address1: | 1707 WATSON BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WARNER ROBINS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310933606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4789298030 | ||||||||
| FaxNumber: | 4789298095 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 07/24/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 041593 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 000765278F | 05 | GA | MEDICAID |