Mohammad Alkofahi

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Oxford, MS

NPI 1902648264 · NPPES record last updated Jun 8, 2024

Key facts

NPI
1902648264
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1100 Belk Blvd
Oxford, MS 38655-5242
Phone
(662) 636-1000
Fax
(662) 636-1670
NPI assigned
Jun 8, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240722003028 MS Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
7012453426

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MS Yes

Addresses

Primary practice location

1100 Belk Blvd
Oxford, MS 38655-5242

Mailing address

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 636-1000

Other providers in Oxford, MS

All providers in Oxford, MS · Student in an Organized Health Care Education/Training Program in Mississippi

Sources for this page

Verify at the official NPI Registry.