DR. BISHARA DAVID BADDOUR (NPI# 1093078388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093078388 |
| Entity Type | Individual |
| Full Name | DR. BISHARA DAVID BADDOUR |
| Credential | M.D. |
| Practice Address |
39 Kent Rd Ste 1 Tifton GA 31794-1698 |
| Practice Telephone | 2293914130 |
| Practice Fax Number | 2293914138 |
| Mailing Telephone | 2293914130 |
| Mailing Fax Number | 2293914138 |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2016-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 068477 | GA | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 036131210 | IL | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 125057259 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
39 KENT RD STE 1 |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-1698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043203920 | Eric G Massa | Podiatrist | 39 Kent Rd, Suite 9, Tifton, GA 31794-1649 | 2005-08-26 |
| 1124679014 | Tift Regional Health System Inc | Family Medicine | 39 Kent Rd, Suite 2, Tifton, GA 31794-1697 | 2019-09-23 |
| 1891235131 | Ankle and Foot Assoc, LLC | Podiatrist | 39 Kent Rd, Suite 9, Tifton, GA 31794-1698 | 2017-03-06 |
| 1205290939 | Lauren B Saxena | Dietitian, Registered | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2016-04-08 |
| 1164857686 | Orthopedic Surgeons of Georgia, LLC | Clinic/Center | 39 Kent Rd, Tifton, GA 31794-1698 | 2013-09-04 |
| 1619310802 | Kelly Renae Grummer-smith | Registered Nurse | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2013-04-08 |
| 1043552334 | Donna B Galliano | Nurse Practitioner | 39 Kent Rd, Suite 1, Tifton, GA 31794-1698 | 2013-03-25 |
| 1710224043 | Tift Regional Health System Inc | Family Medicine | 39 Kent Rd, Suite 1, Tifton, GA 31794-1698 | 2013-01-07 |
| 1285992073 | Kimberly Nicole Works | Pediatrics | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2012-04-30 |
| 1225354525 | Flavia S Rossi | Pediatrics | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2010-04-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275768087 | Rana Abdul-khalek | Obstetrics & Gynecology | 39 Kent Rd Ste 1, Tifton, GA 31794-1697 | 2009-05-22 |
| 1871752907 | Ana Margarita Hernandez Silen | Obstetrics & Gynecology | 1948 Old Ocilla Road, Tifton, GA 31794-1644 | 2008-06-04 |
| 1649281064 | James Andrew Howard | Obstetrics & Gynecology | 1948 Old Ocilla Rd, Tifton, GA 31794-1644 | 2006-08-10 |
| 1346258704 | Darrell W Jordan | Obstetrics & Gynecology | 1006 Greenfield Dr, Tifton, GA 31794-3794 | 2006-08-03 |
| 1891718870 | Shannon L. Price | Obstetrics & Gynecology | 39 Kent Road, Tifton, GA 31794 | 2006-07-25 |
| 1376589556 | Sandra Gail Brickman | Obstetrics & Gynecology | 1806 Lee Aveune, Tifton, GA 31794 | 2006-06-22 |
| 1679514319 | Bridgett Lowe Asbury | Obstetrics & Gynecology | 1806 Lee Ave, Tifton, GA 31794-3639 | 2006-06-10 |
| 1497738561 | David W Adcock II | Obstetrics & Gynecology | 1623 Old Ocilla Rd, Tifton, GA 31794-4173 | 2005-11-22 |
| 1811397060 | Irwin County Hospital | Obstetrics & Gynecology | 72 Kent Rd, Tifton, GA 31794-1694 | 2014-08-25 |
| 1477973410 | United Obstetrics & Gynecology | Obstetrics & Gynecology | 1806 Lee Ave, Tifton, GA 31794-3639 | 2014-04-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.