Basic Information
| Provider Information | |||||||||
| NPI: | 1225128705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADADA | ||||||||
| FirstName: | BADIH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4301 W MARKHAM | ||||||||
| Address2: | #783 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722057101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016868000 | ||||||||
| FaxNumber: | 5015266562 | ||||||||
| Practice Location | |||||||||
| Address1: | 2950 CLEVELAND CLINIC BLVD | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333313609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546595630 | ||||||||
| FaxNumber: | 9546595169 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 03/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | E2981 | AR | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | ME101483 | FL | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 140007318 | 01 | AR | RAILROAD MEDICARE | OTHER | 143714001 | 05 | AR | MEDICAID |