1972291920 NPI number — AMMAR NASER AL HEYASAT MD

Table of content: AMMAR NASER AL HEYASAT MD (NPI 1972291920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972291920 NPI number — AMMAR NASER AL HEYASAT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL HEYASAT
Provider First Name:
AMMAR
Provider Middle Name:
NASER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1972291920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
11/30/2023
NPI Reactivation Date:
02/29/2024

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BEHIND CIVIL DEFENCE MAIN BRANCH OPPOSITE UMNIAH MAIN O
Provider Second Line Business Mailing Address:
ABDUL RAHIM AL-WAKED STREET BUILDING #27
Provider Business Mailing Address City Name:
AL SHUMAYSAN AMMAN
Provider Business Mailing Address State Name:
AMMAN
Provider Business Mailing Address Postal Code:
11194
Provider Business Mailing Address Country Code:
JO
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HOSPITAL DRIVE SOUTHWEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
938-227-6247
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2023

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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