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1679738678

NPI Code Detail

MEDICARE: NIZAR GHAZI AL-NIMRI MD

MEDICARE: NIZAR GHAZI AL-NIMRI MD

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
1	207R00000X	Internal Medicine Physician	2009037641	MO
2	207R00000X	Internal Medicine Physician	41197	OK
3	208M00000X	Hospitalist Physician	2009037641	MO
4	208M00000X	Hospitalist Physician	41197	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1679738678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIZAR GHAZI AL-NIMRI MD

Provider Business Mailing Address
First Line	:	1200 E PECAN ST
Second Line	:
City	:	ALTUS
State	:	OK
Zip	:	73521-6192
Country	:	US
Telephone Number	:	580-379-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 E PECAN ST
Second Line	:
City	:	ALTUS
State	:	OK
Zip	:	73521-6192
Country	:	US
Telephone Number	:	580-379-5000
Fax Number	:	580-379-5999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2008
Last Update Date	:	11/21/2023

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Directions to “ NIZAR GHAZI AL-NIMRI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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