Provider Demographics
NPI:1578880100
Name:BADDOUR, HARRY MICHAEL JR (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:MICHAEL
Last Name:BADDOUR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE STE 1135
Mailing Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2234
Mailing Address - Country:US
Mailing Address - Phone:731-437-0001
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE STE 1135
Practice Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2234
Practice Address - Country:US
Practice Address - Phone:731-437-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73426207YX0007X
GA073426207Y00000X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty