Healthcare Provider Details

I. General information

NPI: 1255713327
Provider Name (Legal Business Name): OMER IQBAL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 01/02/2023
Certification Date: 01/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 LOWELL DR SE STE 102
HUNTSVILLE AL
35801-3755
US

IV. Provider business mailing address

PO BOX 527
HUNTSVILLE AL
35804-0527
US

V. Phone/Fax

Practice location:
  • Phone: 256-715-9598
  • Fax:
Mailing address:
  • Phone: 256-715-9598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO.1670
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: