Provider Demographics
NPI:1689829087
Name:KHOUEIRY, GEORGES M (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGES
Middle Name:M
Last Name:KHOUEIRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16033 DOCTORS BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1479
Mailing Address - Country:US
Mailing Address - Phone:985-974-9278
Mailing Address - Fax:985-269-7103
Practice Address - Street 1:16033 DOCTORS BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1479
Practice Address - Country:US
Practice Address - Phone:985-974-9278
Practice Address - Fax:985-269-7103
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206910207RC0000X
NY263443207RC0000X
NH16173207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2367862Medicaid
VT1021903Medicaid
NH3087027Medicaid
NY03120445Medicaid