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General NPI Number Information
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NPI Number | 1023348398
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Entity Type | Organization
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Legal Business Name | GADSDEN LUNG CENTER, P.C. INC
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 1026 GOODYEAR AVE SUITE 302
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City | GADSDEN
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State | AL
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Zip | 35903-1102
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Country | US
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Telephone | 256-543-3877
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Fax | 256-543-1539
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Provider Business Mailing Address
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Address Line | PO BOX 1859
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City | GADSDEN
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State | AL
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Zip | 35902-1859
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Country | US
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Telephone | 256-543-3877
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Fax | 256-543-1539
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAZEN HAKIM
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Credential | M.D.
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Telephone | 256-543-3877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 17934
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License Number State | AL
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