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NPI Code Detail

MEDICARE: FAREEDA ANN AL REFAI M.D.

MEDICARE: FAREEDA ANN AL REFAI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianC8342AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497735047
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAREEDA ANN AL REFAI M.D.
Provider Business Mailing Address
First Line : PO BOX 1983
Second Line :
City : FORT SMITH
State : AR
Zip : 72902-1983
Country : US
Telephone Number : 479-452-9416
Fax Number : 479-484-0827
Provider Business Practice Location Address
First Line : 1001 TOWSON AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-4921
Country : US
Telephone Number : 479-441-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 05/06/2019

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