Basic Information
Provider Information
NPI: 1528091071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALSEBAI
FirstName: TAMER
MiddleName:  
NamePrefix: PROF.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10001 LILE DR
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722056217
CountryCode: US
TelephoneNumber: 5012278000
FaxNumber:  
Practice Location
Address1: 10001 LILE DR
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722056217
CountryCode: US
TelephoneNumber: 5012278000
FaxNumber: 5012215854
Other Information
ProviderEnumerationDate: 07/08/2006
LastUpdateDate: 04/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XE2787ARY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

ID Information
IDTypeStateIssuerDescription
14546900105AR MEDICAID
5L96901ARBCBSOTHER


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