Healthcare Provider Details

I. General information

NPI: 1841295383
Provider Name (Legal Business Name): ZAKI A SAMMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 TOWSON AVE
FORT SMITH AR
72901-4921
US

IV. Provider business mailing address

PO BOX 402319
ATLANTA GA
30384-2319
US

V. Phone/Fax

Practice location:
  • Phone: 479-709-7435
  • Fax: 479-709-7437
Mailing address:
  • Phone: 479-709-7399
  • Fax: 479-709-7053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberE0870
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: