Individual
MOHAMMAD HASSAN KOUCHEKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., P.C.
Contact information
Practice address
40 ELMO DR, CROSSVILLE, TN 38555-4807
(931) 484-5525
(931) 456-8320
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
12315
TN
208000000X
Pediatrics Physician
Primary
12315
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3172878
—
TN
Enumeration date
12/05/2006
Last updated
06/05/2024
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