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General NPI Number Information
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NPI Number | 1952350233
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Entity Type | Individual
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Provider Name | AHMAD H ALTABBAA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/06/2006
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 3950 NEW COVINGTON PIKE SUITE 290
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City | MEMPHIS
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State | TN
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Zip | 38128-2595
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Country | US
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Telephone | 901-791-2764
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Fax | 901-791-2783
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Provider Business Mailing Address
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Address Line | PO BOX 3836
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City | CORDOVA
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State | TN
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Zip | 38088-3836
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Country | US
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Telephone | 901-791-2764
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Fax | 901-791-2783
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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 | 27191
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 27191
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License Number State | TN
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