Bahram Forouzandeh MD PSC

Organization Active NPI Gastroenterology Physician · Prestonsburg, KY

NPI 1295918787 · NPPES record last updated May 19, 2020

Key facts

NPI
1295918787
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
BAHRAM FOROUZANDEH MD PSC
Practice address
5187 Ky Route 321
Prestonsburg, KY 41653-9114
Phone
(606) 886-7471
Fax
(606) 886-7473
NPI assigned
Dec 7, 2007
Organization subpart
No

Authorized official

Name
Bahram Forouzandeh, MD
Title
Owner
Phone
(606) 886-7471

National Provider Directory

Locations

RT 3 S Kirk PLZ
Kirk PLZ
Inez, KY 41224
Phone (606) 298-7337

RT 3 S Kirk PLZ
Inez, KY 41224
Phone (606) 298-7337

5187 Ky Route 321
Prestonsburg, KY 41653
Phone (606) 886-6388

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RG0100X Yes
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

5187 Ky Route 321
Prestonsburg, KY 41653-9114

Mailing address

PO Box 1375
Prestonsburg, KY 41653-5375
Phone (606) 886-7471

Other identifiers

IdentifierTypeStateIssuer
DB3414OtherKYRAILROAD MEDICARE
6431205100MedicaidKY

Other providers in Prestonsburg, KY

All providers in Prestonsburg, KY · Gastroenterology Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.