Individual
AHMAD ELESBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 W MAPLE AVE, STE 703, SPRINGDALE, AR 72764-5335
(479) 750-2203
Mailing address
601 W MAPLE AVE, STE 703, SPRINGDALE, AR 72764-5335
(479) 750-2203
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
40697
KY
207RC0000X
Cardiovascular Disease Physician
E6699
AR
207RI0011X
Interventional Cardiology Physician
35089719
OH
207RI0011X
Interventional Cardiology Physician
40697
KY
207RI0011X
Interventional Cardiology Physician
Primary
E6699
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184605001
—
AR
01
—
5AF87C072
MEDICARE
AR
01
—
G65530
MEDICARE UPIN
OH
01
—
POO449495
RR MEDICARE
OH
01
—
POO449497
RR MEDICARE
KY
Enumeration date
02/08/2006
Last updated
09/09/2020
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