Abraham N Azan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

RA490 Issued in MO

Practice address

667 E 15TH St
Sedalia, MO 65301-7656

Phone

(660) 827-2525

NPI assigned

Jun 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1154328797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 14TH ST",
            "address_2": "PO BOX 1706",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015972",
            "telephone_number": "866-678-5627",
            "fax_number": "660-827-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 E 15TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017656",
            "telephone_number": "660-827-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAN",
        "first_name": "ABRAHAM",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "RA490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "160059401",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201280427",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08571025",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Arnold, LCSW
• Kirstin Arnold, LAT, ATC
• Whitney D Arnold, PHARM.D.
• Mirna Asham, MD
• Karla Damille Aubrey, RRT-NPS
• Kenneth Najeeb Azan, MD
• Nohaud Naseef Azan, DDS
• Laura Lynn Aziere, MS, PLPC
• Back in Action Chiropractic LLC
• Jeffrey E Backe

• Family Medicine Physician in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.