Provider Demographics
NPI:1649234998
Name:HAROUN, RAMZI A (MD)
Entity type:Individual
Prefix:
First Name:RAMZI
Middle Name:A
Last Name:HAROUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1724 KENTON ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1981
Mailing Address - Country:US
Mailing Address - Phone:270-886-7480
Mailing Address - Fax:270-886-7532
Practice Address - Street 1:1724 KENTON ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1981
Practice Address - Country:US
Practice Address - Phone:270-886-7480
Practice Address - Fax:270-886-7532
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31533208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64315336Medicaid
KY000000067579OtherANTHEM BCBS
KY000000067579OtherANTHEM BCBS