Provider Demographics
NPI:1982408845
Name:AL-AIZARI, AHMED YAHYA (DO)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:YAHYA
Last Name:AL-AIZARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9662
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-9662
Mailing Address - Country:US
Mailing Address - Phone:501-852-1363
Mailing Address - Fax:501-852-1364
Practice Address - Street 1:1700 ALTUS ST STE 110
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4299
Practice Address - Country:US
Practice Address - Phone:501-852-1366
Practice Address - Fax:501-852-1367
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program