Charles Moussallem
Nephrologist
1500 Dodson Ave Suite 280
Fort Smith
, Arkansas 72901-5182
Charles Moussallem
Nephrologist
1500 Dodson Ave Suite 280
Fort Smith
, Arkansas 72901-5182
(479) 709-7053
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Charles Moussallem
- 1500 Dodson Ave # 280
- Fort Smith, AR
- Zip : 72901-5182
- Fax : (479) 709-7053
- Phone : (479) 709-7399
Second Address
- Charles Moussallem
- 1500 Dodson Ave Suite 280
- Fort Smith, AR
- Zip : 72901-5182
- Fax : (479) 709-7479
- Phone : (479) 709-7480
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Is Charles Moussallem a sole practitioner?
Is Charles Moussallem accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | E-8013 | AR |
National Provider Identifier
| NPI | 1023318334 |
|---|---|
| Provider Name | Charles Moussallem |
| First Address | Fort Smith, AR 72901-5182 |
| Second Address | Fort Smith, AR 72901-5182 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/11/2010 |
| Last Update Date | 27/11/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200504590A | (05) | OK |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.