MEDICARE: DR. HENEIN T. ISKANDER

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	208600000X	Surgery Physician	R3460	AR

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	:	1760458061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENEIN T. ISKANDER

Provider Business Mailing Address
First Line	:	PO BOX 749
Second Line	:
City	:	FORREST CITY
State	:	AR
Zip	:	72336-0749
Country	:	US
Telephone Number	:	870-633-7940
Fax Number	:	870-630-6411

Provider Business Practice Location Address
First Line	:	900 HOLIDAY DR
Second Line	:	SUITE 105
City	:	FORREST CITY
State	:	AR
Zip	:	72335-9183
Country	:	US
Telephone Number	:	870-633-7940
Fax Number	:	870-630-6411

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/21/2010

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Directions to “ DR. HENEIN T. ISKANDER ” Practice Location

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