Individual
DR. TAWAN SUNNY KHAMAPIRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6005 PARK AVE, STE 624B, MEMPHIS, TN 38119-5221
(901) 682-1100
(901) 682-6915
Mailing address
PO BOX 1000 DEPT 448, MEMPHIS, TN 38148-0448
(901) 682-1100
(901) 682-6915
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
18267
MS
207W00000X
Ophthalmology Physician
Primary
37817
TN
207W00000X
Ophthalmology Physician
E3846
AR
207WX0107X
Retina Specialist (Ophthalmology) Physician
18267
MS
207WX0107X
Retina Specialist (Ophthalmology) Physician
37817
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
E3846
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04635763
—
MS
05
—
3886759
—
TN
01
—
4067262
BLUE CROSS
TN
Enumeration date
06/17/2005
Last updated
04/26/2017
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