Provider Demographics
NPI:1073967048
Name:MOTAHARI, HOOMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOOMAN
Middle Name:
Last Name:MOTAHARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HOOMAN
Other - Middle Name:MOTAHARI
Other - Last Name:FARIMANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9662
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-9662
Mailing Address - Country:US
Mailing Address - Phone:501-852-1363
Mailing Address - Fax:501-852-1364
Practice Address - Street 1:525 WESTERN AVE STE 305B
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4982
Practice Address - Country:US
Practice Address - Phone:501-205-4990
Practice Address - Fax:501-205-4993
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-14647207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism