Provider Demographics
NPI:1922097252
Name:HAMOUCHE, NICOLAS GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:GEORGE
Last Name:HAMOUCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLAS
Other - Middle Name:GEORGE
Other - Last Name:HAMUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1018 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5740
Mailing Address - Country:US
Mailing Address - Phone:515-239-4460
Mailing Address - Fax:515-239-4437
Practice Address - Street 1:1128 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5776
Practice Address - Country:US
Practice Address - Phone:515-663-4888
Practice Address - Fax:515-956-4199
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34156207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0238089Medicaid
IAF31263Medicare UPIN
IA0238089Medicaid