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Individual

DR. IMAD TAHBOUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
(601) 249-1173
Mailing address
PO BOX 490, MCCOMB, MS 39649-0490
(601) 250-4366
(601) 250-4367

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23349
MS
207R00000X
Internal Medicine Physician
31196
AL
207R00000X
Internal Medicine Physician
IT053374
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03404537
MS
05
131779
AL
Enumeration date
09/27/2005
Last updated
04/29/2021
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