Provider Demographics
NPI:1831298421
Name:HATOUM, GEORGES F (MD)
Entity Type:Individual
Prefix:
First Name:GEORGES
Middle Name:F
Last Name:HATOUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4685 SOUTH CONGRESS AVE
Mailing Address - Street 2:JFK COMPREHENSIVE CANCER INSTITUTE
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461
Mailing Address - Country:US
Mailing Address - Phone:561-548-2662
Mailing Address - Fax:561-548-1633
Practice Address - Street 1:4685 SOUTH CONGRESS AVE
Practice Address - Street 2:JFK COMPREHENSIVE CANCER INSTITUTE
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461
Practice Address - Country:US
Practice Address - Phone:561-548-2662
Practice Address - Fax:561-548-1633
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME969512085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276708200Medicaid