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Organization
MANOOCHEHR MAZLOOMDOOST PSC
Active
Organization
MANOOCHEHR MAZLOOMDOOST PSC
Active
Other names
Pain Management Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANESH MAZLOOMDOOST M.D. (PRESIDENT)
(859) 275-4878
Entity
Organization
Contact information
Practice address
715 SHAKER DR, SUITE 132, LEXINGTON, KY 40504-3662
(859) 275-4878
(859) 276-5400
Mailing address
715 SHAKER DR, SUITE 132, LEXINGTON, KY 40504-3662
(859) 275-4878
(859) 276-5400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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