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General NPI Number Information
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NPI Number | 1225317589
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Entity Type | Individual
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Provider Name | FIRAS KADDOUH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 01/06/2024
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Provider Practice Location Address
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Address Line | 1625 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85719-4330
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Country | US
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Telephone | 520-694-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 800 N COUNTRY CLUB RD APT 3433
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City | TUCSON
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State | AZ
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Zip | 85716-4556
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Country | US
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Telephone | 203-314-6767
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Fax |
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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 | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | 62254
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 62254
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 68594
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | 68594
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License Number State | AZ
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