Healthcare Provider Details

I. General information

NPI: 1801575329
Provider Name (Legal Business Name): ARIF ZULFIQAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 HOSPITAL DR STE 205
MACON GA
31217-8025
US

IV. Provider business mailing address

2500 NORTH STATE STREET UMMC DEPARTMENT OF FAMILY MEDICINE
JACKSON MS
39216
US

V. Phone/Fax

Practice location:
  • Phone: 478-765-4530
  • Fax:
Mailing address:
  • Phone: 601-984-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number114155
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT-5171
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: