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General NPI Number Information
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NPI Number | 1073592572
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Entity Type | Organization
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Legal Business Name | HEART CENTER OF SOMERSET PLLC
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 104 HARDIN LN SUITE B
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City | SOMERSET
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State | KY
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Zip | 42503-3800
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Country | US
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Telephone | 606-677-1112
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Fax | 606-679-1341
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Provider Business Mailing Address
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Address Line | 104 HARDIN LN SUITE B
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City | SOMERSET
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State | KY
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Zip | 42503-3800
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Country | US
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Telephone | 606-677-1112
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Fax | 606-679-1341
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Authorized Official
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Title or Position | PHYSICIAN
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Name | IBRAIZ IQBAL
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Credential | MD
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Telephone | 606-677-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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