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General NPI Number Information
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NPI Number | 1063407534
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Entity Type | Individual
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Provider Name | MOHAMMAD A ALSOUB MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 111 HIGHWAY 70 E STE 102
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City | DICKSON
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State | TN
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Zip | 37055-2080
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Country | US
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Telephone | 615-375-1531
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Fax | 615-375-1526
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Provider Business Mailing Address
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Address Line | 127 CRESTVIEW PARK DR STE 209
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City | DICKSON
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State | TN
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Zip | 37055-2856
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Country | US
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Telephone | 615-446-5121
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Fax | 615-446-1359
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 38437
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 38437
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License Number State | TN
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