Active NPI
Rafik B Kashlan, M.D.
- Surgery Physician
- Jonesboro, GA
National Provider Identifier
1306852074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 020751
- Practice address
- 242 Arrowhead Blvd
Jonesboro, GA 30236-1106 - Phone
- (770) 472-0472
- Fax
- (770) 472-9970
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 020751 | GA | Primary |
Addresses
Primary practice location
242 Arrowhead Blvd
Jonesboro, GA 30236-1106
Mailing address
242 Arrowhead Blvd
Jonesboro, GA 30236-1106
Phone (770) 472-0472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000221779A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020751 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1306852074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 ARROWHEAD BLVD",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302361106",
"telephone_number": "770-472-0472",
"fax_number": "770-472-9970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 ARROWHEAD BLVD",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302361106",
"telephone_number": "770-472-0472",
"fax_number": "770-472-9970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASHLAN",
"first_name": "RAFIK",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "020751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000221779A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.