Provider Demographics
NPI:1609096585
Name:TAMADDON, HOUMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOUMAN
Middle Name:
Last Name:TAMADDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HOUMAN
Other - Middle Name:
Other - Last Name:TAMADDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-774-7263
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:1350 WALTON WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2612
Practice Address - Country:US
Practice Address - Phone:706-774-7022
Practice Address - Fax:706-774-7023
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA630322086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery