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Contact Information

MORTEZA SHAFA, MD
245 BROADWAY ST.
LA CENTER, KY42056
 Phone: 270-665-9195
 Fax: 270-665-5420
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MORTEZA SHAFA · (Male)

NPI Number 1669407458
Status Active
Credentials MD
Entity Individual
Enumeration date 07/11/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 22367
  • KY Medicaid 64223670
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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