Individual
DR. FAREED KANNOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 TOWSON AVE STE 101-N, FORT SMITH, AR 72901-7961
(479) 274-6900
(479) 648-3951
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-0453
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110181109
RR MEDICARE
—
05
—
127260001
—
AR
Enumeration date
07/24/2006
Last updated
08/28/2015
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