Healthcare Provider Details

I. General information

NPI: 1326089947
Provider Name (Legal Business Name): AGHA JAMIL AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMIL AHMED M.D.

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 N WALDRON ST
HUTCHINSON KS
67502-1131
US

IV. Provider business mailing address

2101 N WALDRON ST
HUTCHINSON KS
67502-1131
US

V. Phone/Fax

Practice location:
  • Phone: 620-669-2500
  • Fax: 620-669-2597
Mailing address:
  • Phone: 620-669-2500
  • Fax: 620-694-4225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number23272
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number04-34135
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: