1386393932 NPI number — AHMED MUAAZ UMER MBBS

Table of content: AHMED MUAAZ UMER MBBS (NPI 1386393932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386393932 NPI number — AHMED MUAAZ UMER MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UMER
Provider First Name:
AHMED
Provider Middle Name:
MUAAZ
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MBBS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386393932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 E WASHINGTON AVENUE
Provider Second Line Business Mailing Address:
603 EAST NETTLETON AVENUE, JONESBORO, AR, 72401
Provider Business Mailing Address City Name:
JONESBORO
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-207-1539
Provider Business Mailing Address Fax Number:
870-207-6581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 E WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JONESBORO
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72401-3111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-207-1539
Provider Business Practice Location Address Fax Number:
870-207-6581
Provider Enumeration Date:
03/21/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  E-19625 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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