Healthcare Provider Details

I. General information

NPI: 1881182665
Provider Name (Legal Business Name): HAMMAD ALI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date: 11/29/2018
Reactivation Date: 12/31/2018

III. Provider practice location address

135 E MAXWELL ST STE 301
LEXINGTON KY
40508-2623
US

IV. Provider business mailing address

469 HIGHWAY 50
GILLETTE WY
82718-9330
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-5350
  • Fax:
Mailing address:
  • Phone: 307-387-9850
  • Fax: 307-387-9850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number55431
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number18244A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: