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General NPI Number Information
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NPI Number | 1851421705
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Entity Type | Individual
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Provider Name | FARIS AL-GEBORY M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 1325 EASTMORELAND AVE STE 310
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City | MEMPHIS
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State | TN
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Zip | 38104-7544
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Country | US
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Telephone | 901-758-7970
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Fax | 901-266-6425
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Provider Business Mailing Address
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Address Line | 12236 WINROCK DR
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6642
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Country | US
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Telephone | 314-432-5144
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2008032789
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036131427
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD11328
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 61934
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License Number State | TN
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