1770151227 NPI number — ABDALLAH YOUSEF SULEIMAN ALMEGDADI MBBS

Table of content: ERRY KINLOCK (NPI 1396162616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770151227 NPI number — ABDALLAH YOUSEF SULEIMAN ALMEGDADI MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALMEGDADI
Provider First Name:
ABDALLAH
Provider Middle Name:
YOUSEF SULEIMAN
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:
1770151227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/01/2022
NPI Reactivation Date:
12/01/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1551 DOCTORS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAGRANGE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30240-4139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-803-7490
Provider Business Mailing Address Fax Number:
770-999-2819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1551 DOCTORS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAGRANGE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30240-4139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-803-7490
Provider Business Practice Location Address Fax Number:
770-999-2819
Provider Enumeration Date:
06/11/2021

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: 207QS1201X , with the licence number:  104594 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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