Rafieetary, Mohammad Reza

Rafieetary, Mohammad Reza is an individual health care provider with primary practice located at 1432 Kimbrough Rd , Germantown TN 38138-2405. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Rafieetary, Mohammad Reza can be contacted via phone (901) 767-4499.

Contact Information

Primary practice address
1432 Kimbrough Rd Germantown TN 38138-2405
Phone: (901) 767-4499
Fax: (901) 761-0727
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X OD1200 Tennessee

Profile Details

NPI number 1750384541
LBN Legal business name Rafieetary, Mohammad Reza
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Mar 29th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750384541 NPPES
Tennessee MEDICAID 0169638

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