Provider Demographics
NPI:1124070677
Name:KARZOUN, NOUR ADIEN (MD)
Entity type:Individual
Prefix:
First Name:NOUR
Middle Name:ADIEN
Last Name:KARZOUN
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 1:30752 MILL RACE DR
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:TN
Mailing Address - Zip Code:38449-3115
Mailing Address - Country:US
Mailing Address - Phone:931-427-4117
Mailing Address - Fax:
Practice Address - Street 1:1275 E COLLEGE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4500
Practice Address - Country:US
Practice Address - Phone:931-363-2925
Practice Address - Fax:931-363-9563
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000038361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3895550Medicaid
TN3895550Medicare ID - Type Unspecified
TN3895550Medicaid