Provider Demographics
NPI:1770171209
Name:YOUSSEF, HOSSAM IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:HOSSAM
Middle Name:IBRAHIM
Last Name:YOUSSEF
Suffix:
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 1:6020 WARDEN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6015
Mailing Address - Country:US
Mailing Address - Phone:501-552-6400
Mailing Address - Fax:
Practice Address - Street 1:6020 WARDEN RD STE 100
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-6015
Practice Address - Country:US
Practice Address - Phone:501-552-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-10
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10070071207T00000X
ARR-4723207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty