Provider Demographics
NPI:1104832161
Name:BOKHARI, HAMMAD H (MD)
Entity type:Individual
Prefix:
First Name:HAMMAD
Middle Name:H
Last Name:BOKHARI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 PEACH BLOSSOM DR STE 101
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-8380
Mailing Address - Country:US
Mailing Address - Phone:812-590-1600
Mailing Address - Fax:812-590-6561
Practice Address - Street 1:2916 PEACH BLOSSOM DR STE 101
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-8380
Practice Address - Country:US
Practice Address - Phone:812-590-1600
Practice Address - Fax:812-590-6561
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38271207Q00000X, 207Q00000X
IN01057661A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCS1632000276OtherCARESOURCE
KYP00149170OtherRAILROAD MEDICARE
KYP01729280OtherRAILROAD MEDICARE - PALMETTO
KY000001014920OtherANTHEM BCBS
KY64070477Medicaid
KY000000305211OtherANTHEM PROVIDER ID
KYDA2673OtherRR MEDICARE GRP
KYCS1632000276OtherHUMANA-CARESOURSE
H82178Medicare UPIN
KY64070477Medicaid