Mokhtari, Susan

Mokhtari, Susan is an individual health care provider with primary practice located at 1910 Nonconnah Blvd Suite 120, Memphis TN 38132-2113. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is her primary health care specialty. Mokhtari, Susan can be contacted via phone (901) 448-2300.

Contact Information

Primary practice address
1910 Nonconnah Blvd Suite 120 Memphis TN 38132-2113
Phone: (901) 448-2300
Fax: (901) 448-6657
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 27884 Tennessee
Allopathic & Osteopathic Physicians / Addiction Medicine 207LA0401X 18474 Mississippi

Profile Details

NPI number 1225138423
LBN Legal business name Mokhtari, Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 15th, 2022 - about 2 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 1225138423 NPPES
Tennessee MEDICAID 3836655

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