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General NPI Number Information
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NPI Number | 1699748806
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Entity Type | Individual
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Provider Name | AHMAD ELESBER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 601 W MAPLE AVE STE 703
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-750-2203
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Fax |
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Provider Business Mailing Address
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Address Line | 601 W MAPLE AVE STE 703
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-750-2203
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E6699
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | E6699
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 40697
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 35089719
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 40697
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License Number State | KY
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