Provider Demographics
NPI:1144546375
Name:MAKHNI CARDIOLOGY AND MEDICAL ASSOCIATES PA
Entity type:Organization
Organization Name:MAKHNI CARDIOLOGY AND MEDICAL ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARVEEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAKHNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-942-3409
Mailing Address - Street 1:980 HIGHWAY 28
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3695
Mailing Address - Country:US
Mailing Address - Phone:423-942-3409
Mailing Address - Fax:423-942-3410
Practice Address - Street 1:980 HIGHWAY 28
Practice Address - Street 2:SUITE 101
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3695
Practice Address - Country:US
Practice Address - Phone:423-942-3409
Practice Address - Fax:423-942-3409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45662208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty