Individual
FOUAD VICTOR ATALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1048 ASHLEY ST STE 303, BOWLING GREEN, KY 42103-2451
(270) 796-8960
(270) 842-5683
Mailing address
1048 ASHLEY ST STE 303, BOWLING GREEN, KY 42103-2451
(270) 796-8960
(270) 842-5683
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
33744
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64337447
—
KY
Enumeration date
09/27/2005
Last updated
10/07/2020
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