Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | ME21215 | FL |
Y | 2086S0129X | Vascular Surgeon | ME21215 | FL |
NPI | 1093746331 |
---|---|
Provider Name | Dr. Abdul Jabbar Barhoush |
First Address | Ocala, FL 34471-3729 |
Second Address | Ocala, FL 34474-4221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 20/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
053996100 | (05) | FL |
42103 | BLUE CROSS & BLUE SHIELD (01) | FL |
D85721 | (02) | FL |