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General NPI Number Information
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NPI Number | 1225611494
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Entity Type | Individual
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Provider Name | ALI RAZA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 440 HOPKINSVILLE ST STE 2E
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City | GREENVILLE
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State | KY
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Zip | 42345-1124
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Country | US
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Telephone | 270-338-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 240 HOSPITAL RD
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City | WHITESBURG
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State | KY
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Zip | 41858-7627
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Country | US
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Telephone | 606-633-6151
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Fax | 606-633-6205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 60467
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License Number State | KY
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