MANOOCHEHR MAZLOOMDOOST PSC (NPI# 1720110182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720110182 |
| Entity Type | Organization |
| Organization Name | MANOOCHEHR MAZLOOMDOOST PSC |
| Other Organization Name | PAIN MANAGEMENT MEDICINE |
| Practice Address |
103 Greer Lane Corbin KY 40701 |
| Mailing Address |
715 Shaker Drive Suite 101 Lexington KY 40502 |
| Practice Telephone | 6065282298 |
| Practice Fax Number | 6065282217 |
| Mailing Telephone | 8592754878 |
| Mailing Fax Number | 8592765400 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2011-11-04 |
| Authorized Official Name | MANNOCHEHR MAZLOOMDOOST (DIRECTOR) |
| Authorized Official Telephone | 8592754878 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 17083 | KY | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Pain Management Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063711018 | Manoochehr Mazloomdoost Psc | Psychiatry & Neurology | 715 Shaker Dr, Suite 132, Lexington, KY 40504-3662 | 2011-03-16 |
| Street Address |
103 GREER LANE |
| City | CORBIN |
| State | KY |
| Zip Code | 40701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880640 | Kristie Lynn Hale | Nurse Practitioner | 521 East Cumberland Gap Parkway, Suite 1, Corbin, KY 40701 | 2020-10-29 |
| 1376014183 | Ruth Ann Thornhill | Nurse Practitioner | 521 E. Cumberland Gap Parkway #1, Corbin, KY 40701 | 2018-12-06 |
| 1770066136 | Grace Community Health Center, Inc. | Psychologist | 50 Ed Mcneel Drive, Corbin, KY 40701 | 2018-09-12 |
| 1235610353 | Linda Bales | Occupational Therapist | 112 Commonwealth Avenue, Corbin, KY 40701 | 2018-08-27 |
| 1710465398 | Holly Davina Bingham | Counselor | 1203 Amercn Grtg Card Rd, Corbin, KY 40701 | 2018-08-05 |
| 1881134914 | Angie Mossie Ledford | Nurse Practitioner | 521 Cumberland Gap Parkway #1, Corbin, KY 40701 | 2017-03-08 |
| 1669915609 | Energized Therapy | Occupational Therapist | 702 Phillips Lane, Corbin, KY 40701 | 2016-11-23 |
| 1649635293 | Debra Ann Hipsher | Counselor | 967 South Hwy 25 West, Corbin, KY 40701 | 2015-12-28 |
| 1356729438 | Sean William James | Family Medicine | 14949 N Us Highway 25 E Ste 4, Corbin, KY 40701 | 2015-05-11 |
| 1962847285 | Angela Davidson Gabbard | Dentist | 129 S. Hwy 1223, Corbin, KY 40701 | 2013-04-30 |
| Find all providers in zip 40701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851703599 | Lisa Ann Maynes | Specialist | 348 S Highway 1223, Corbin, KY 40701-4643 | 2014-05-29 |
| 1407180953 | Annette L. Goodin | Specialist | 212 Brandon Dr, Corbin, KY 40701-4253 | 2009-09-30 |
| 1588870489 | Susanne Potter | Specialist | 441 Hwy 2417, Corbin, KY 40701 | 2007-05-15 |
| 1457386609 | Larry Edward Taylor | Specialist | 1705 Forest Dr, Corbin, KY 40701-2354 | 2006-07-12 |
| 1063416741 | David Edward Muffly | Specialist | 1490 Cumberland Falls Hwy, Corbin, KY 40701-2721 | 2005-06-09 |
| 1760656797 | Allergy Associates, P.a. | Specialist | 1317 Cumberland Falls Hwy, Suite A, Corbin, KY 40701-2720 | 2008-04-22 |
| 1265638076 | Women's Wellness Center of Corbin, Pllc | Specialist | 1705 Forest Dr, Corbin, KY 40701-2354 | 2007-06-27 |
| 1760600126 | Kevin J Croce | Specialist | 1 Trillium Way, Corbin, KY 40701-8727 | 2007-04-23 |
| 1700928140 | Melissa L F Knuckles Md Psc | Specialist | 1101 East Master Street, Corbin, KY 40701-3511 | 2007-02-13 |
| 1689767543 | Khaled Saleh | Specialist | 45 Moonbow Plz, Corbin, KY 40701 | 2006-10-02 |
| Find all providers in CORBIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.