National Provider Identifier Database

OMAR F GHANDOUR, MD – NPI #1255323663
Radiation Oncology

A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.


Contact Information

OMAR F GHANDOUR, MD
7601 SOUTHCREST PKWY
SOUTHAVEN, MS38671-4739
Phone: 662-772-2130
Fax: 662-772-2131
Website:
Specialty Taxonomy Code
* Radiation Oncology 2085R0001X

* Indicates primary specialty

NPI Profile & details for OMAR F GHANDOUR

NPI Number 1255323663
Credentials MD
Entity Individual
Enumeration date 08/22/2005
Last updated 03/30/2018 - About 8 years ago
Sole proprietor1 No
Identifiers
  • MS License #: 22217
  • TN License #: 36779
  • AR Medicaid: 148872001
  • MS Medicaid: 00127062
  • TN Medicaid: 3876529
  • Other: 7160133 AETNA
  • AR Other: 99465 BLUE CROSS BLUE SHIELD
  • TN Other: 4046696 BLUE CROSS BLUE SHIELD
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for OMAR F GHANDOUR, MD

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