Organization
INTERNAL MEDICINE PRIMARY CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMAD TAHBOUB MD (OWNER)
(601) 519-0509
Entity
Organization
Contact information
Practice address
140 DAUGHDRILL STA, FLOWOOD, MS 39232-8406
(601) 519-0509
Mailing address
140 DAUGHDRILL STA, FLOWOOD, MS 39232-8406
(601) 519-0509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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