Individual
MOKHTAR HACENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2054 WATSON BLVD, WARNER ROBINS, GA 31093-3634
(478) 918-0770
(478) 918-0771
Mailing address
2054 WATSON BLVD, WARNER ROBINS, GA 31093-3634
(478) 918-0770
(478) 918-0771
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
055062
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257348755B
—
GA
01
—
P00332224
MEDICARE RAILROAD#
GA
Enumeration date
05/26/2006
Last updated
07/23/2008
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