| Organization Name: | SOUTH OTOLARYNGOLOGY-HEAD AND NECK SURGERY, LLC |
| NPI Number: | 1881019537 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TARIK Y FARRAG (PRESIDENT/PHYSICIAN) |
| Mailing Address: | 511 Brantley St Opp |
| State: | AL US |
| Postal Code: | 364671702 |
| Phone Number: | 3344933240 |
| Fax Number: | 3344939535 |
| NPI Enumeration Date: | 03/04/2014 |
| NPI Last Update Date: | 03/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YX0905X |
| License Number: | MD.32237 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Otolaryngology/Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |