1104832161 NPI number — HAMMAD H. BOKHARI MD

Table of content: ERIC JAMES BOYER PA-C (NPI 1386948891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104832161 NPI number — HAMMAD H. BOKHARI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOKHARI
Provider First Name:
HAMMAD
Provider Middle Name:
H.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104832161
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2916 PEACH BLOSSOM DR STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEFFERSONVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47130-8380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-590-1600
Provider Business Mailing Address Fax Number:
812-590-6561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2916 PEACH BLOSSOM DR STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEFFERSONVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47130-8380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-590-1600
Provider Business Practice Location Address Fax Number:
812-590-6561
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  38271 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 01057661A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CS1632000276 . This is a "CARESOURCE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00149170 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P01729280 . This is a "RAILROAD MEDICARE - PALMETTO" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000001014920 . This is a "ANTHEM BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64070477 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000305211 . This is a "ANTHEM PROVIDER ID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: DA2673 . This is a "RR MEDICARE GRP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: CS1632000276 . This is a "HUMANA-CARESOURSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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