Organization Active NPI

Dr. Abdulkader Dahhan PSC

  • Internal Medicine Physician
  • Harlan, KY
National Provider Identifier
1043355290
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17192 Issued in KY
Legal business name
DR. ABDULKADER DAHHAN PSC
Practice address
120 Professional LN Ste 101
Harlan, KY 40831-2601
Phone
(606) 573-1085
Fax
(606) 573-9956
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Sandy Johnson, RMA
Title
Office Manager
Phone
(606) 573-1085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 17192 KY Primary

Addresses

Primary practice location

120 Professional LN Ste 101
Harlan, KY 40831-2601

Mailing address

120 Professional LN Ste 101
Harlan, KY 40831-2601
Phone (606) 573-1085

Other identifiers 1

IdentifierTypeStateIssuer
64171929MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1043355290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL LN STE 101",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408312601",
            "telephone_number": "606-573-1085",
            "fax_number": "606-573-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL LN STE 101",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408312601",
            "telephone_number": "606-573-1085",
            "fax_number": "606-573-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ABDULKADER DAHHAN PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-573-1085",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RMA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "17192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64171929",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.