Individual
FAKHRI DALATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(662) 244-2042
(662) 244-2041
Mailing address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19516
MS
208M00000X
Hospitalist Physician
Primary
38826
TN
208M00000X
Hospitalist Physician
50204
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3335918
—
TN
01
—
4129687
BCBS
TN
05
—
7100010830
—
KY
Enumeration date
05/11/2006
Last updated
06/25/2024
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