LEILA KHADDOUR


Address: 3123 Medical Dr, Caldwell, ID 83605-6972
Phone: 2083673131

LEILA KHADDOUR (NPI# 1750797486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750797486
Entity Type Individual
Full Name LEILA KHADDOUR
Credential MD
Practice Address 3123 Medical Dr
Caldwell
ID 83605-6972
Mailing Address 3340 E Goldstone Dr
Meridian
ID 83642-1026
Practice Telephone 2083673131
Practice Fax Number 2083674817
Mailing Telephone 2083675170
Mailing Fax Number 2083675180
Enumeration Date 2014-07-02
Last Update Date 2020-09-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 4301105339 MI Allopathic & Osteopathic Physicians
Y 207RX0202X Internal Medicine
Specialization: Medical Oncology
MC-0480 ID Allopathic & Osteopathic Physicians
N 207RX0202X Internal Medicine
Specialization: Medical Oncology
4301105339 MI Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
2799 W Grand Blvd, Detroit, MI 482022608 (313) 916-2600

Office Location

Street Address 3123 MEDICAL DR
City CALDWELL
State ID
Zip Code 83605-6972

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053522961 Saint Alphonsus Caldwell Cancer Treatment Center LLC Radiologic Technologist 3123 Medical Dr, Caldwell, ID 83605-6911 2007-05-24
1598956963 Bobby Chawla Internal Medicine 3123 Medical Dr, Caldwell, ID 83605 2007-08-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518585660 Laurie Bernstein Occupational Therapist 2205 Sunset Avenue, Caldwell, ID 83605 2020-07-06
1881249316 Elevate Academy Local Education Agency (LEA) 114 W. Chicago St., Caldwell, ID 83605 2019-08-01
1669025359 James Smith Pharmacist 2809 E Caldwell Blvd, Caldwell, ID 83605 2019-07-22
1164910824 Michelle Stoddard Physician Assistant 315 E Elm St Ste 200, Caldwell, ID 83605 2018-04-27
1215430483 Amy E Rudolf Pharmacist 315 E Elm St Ste 150, Caldwell, ID 83605 2018-03-14
1871044883 Kool Ridez LLC Case Management 1803 Ellis Ave., Caldwell, ID 83605 2016-10-14
1932550795 Chris Torgerson Social Worker 3402 Franklin Blvd, Caldwell, ID 83605 2016-06-23
1609237742 Peggy A Mcfarland Counselor 534 Cleveland Suite 230, Caldwell, ID 83605 2016-03-17
1720468101 Devin Douglas Dredge Emergency Medicine 1717 Arlington Ave Dept Of, Caldwell, ID 83605 2015-06-01
1578950168 Trinidad Bridge Licensed Practical Nurse 2909 S. 10th Avenue, Caldwell, ID 83605 2015-04-21
Find all providers in zip 83605

Taxonomy Information

Taxonomy Code 207RX0202X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Medical Oncology

Taxonomy Definition

An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1376567487 Teresa Gray Hayes Internal Medicine 700 W Ironwood Dr Ste 130, Coeur D Alene, ID 83814-4404 2006-07-26
1215981832 Gerardo Midence Internal Medicine 1250 Idaho Street, Lewiston, ID 83501 2006-05-19
1821355330 Jessica Thibault Internal Medicine 725 Pole Line Rd W, Twin Falls, ID 83301 2012-04-20
1417214420 Nathanael David Gay Internal Medicine 1440 E Mullan Ave, Post Falls, ID 83854 2012-04-15
1629095179 St Alphonsus Professional Medical Services LLC Internal Medicine 1055 N Curtis Rd, Boise, ID 83706-1309 2006-07-17
1265478325 Karl Josef Schultheiss Internal Medicine 1055 N Curtis Rd, Boise, ID 83706 2006-06-20
1093753360 Michael Rooney Internal Medicine 415 6th St, Lewiston, ID 83501-2431 2006-06-02
1083668248 Sushma Pant Internal Medicine 1250 Idaho Street, Lewiston, ID 83501 2006-05-20
1821042029 Katrina A Rolen Internal Medicine 1250 Idaho Street, Lewiston, ID 83501 2006-05-20

Competitor

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City CALDWELL
Zip Code 83605

Improve Information

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Dataset Information

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.

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