Provider Demographics
NPI:1861689168
Name:YOUSEF F. KHOURI, MD, PC
Entity Type:Organization
Organization Name:YOUSEF F. KHOURI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSEF
Authorized Official - Middle Name:F
Authorized Official - Last Name:KHOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-355-1843
Mailing Address - Street 1:1304 13TH AVE SE
Mailing Address - Street 2:SUITE P
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-355-1843
Mailing Address - Fax:256-340-2553
Practice Address - Street 1:1304 13TH AVE SE
Practice Address - Street 2:SUITE P
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-355-1843
Practice Address - Fax:256-340-2553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17772208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529914530Medicaid