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NPI Code Detail

MEDICARE: HARRY MICHAEL BADDOUR JR. M.D.

MEDICARE: HARRY MICHAEL BADDOUR JR. 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
1207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) Physician73426GA

General Provider Information

NPI Number : 1578880100
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARRY MICHAEL BADDOUR JR. M.D.
Provider Business Mailing Address
First Line : 550 PEACHTREE ST NE STE 1135
Second Line : DEPARTMENT OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY
City : ATLANTA
State : GA
Zip : 30308-2234
Country : US
Telephone Number : 731-437-0001
Fax Number :
Provider Business Practice Location Address
First Line : 550 PEACHTREE ST NE STE 1135
Second Line : DEPARTMENT OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY
City : ATLANTA
State : GA
Zip : 30308-2234
Country : US
Telephone Number : 731-437-0001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2010
Last Update Date : 06/06/2022

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