HOMAYOUN MODARRESIFAR MD NPI 1235146648

NPI Information

NPI: 1235146648
Provider Name: HOMAYOUN MODARRESIFAR, MD
Classification: Nuclear Medicine - 207UN0902X
Entity Type: Individual

Specialization: Nuclear Imaging & Therapy

Address:
2109 W MARKET ST STE 122
ETSU, INNOVATION LABORATORY
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 439-8000
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Homayoun Modarresifar, MD is a nuclear imaging and therapy nuclear medicine in Johnson City, TN. The provider is a nuclear medicine physician who specializes in nuclear imaging and therapy. Homayoun Modarresifar, MD NPI is 1235146648. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2109 W MARKET ST STE 122
ETSU, INNOVATION LABORATORY
JOHNSON CITY, TN
ZIP 37604-024
Phone: (423) 439-8000

The enumeration date for this NPI number is 8/1/2006 and was last updated on 5/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207UN0902X	Nuclear Medicine	Nuclear Imaging & Therapy	A93513	CALIFORNIA	No
2	207UN0902X	Nuclear Medicine	Nuclear Imaging & Therapy	N5255	TEXAS	No
3	207U00000X	Nuclear Medicine		41198	ARIZONA	No
4	207UN0902X	Nuclear Medicine	Nuclear Imaging & Therapy	MD0000046850	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MD0000046850	OTHER	TENNESSEE	TENNESSEE MEDICAL LICENSE
2	Z126506	MEDICARE PIN	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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