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General NPI Number Information
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NPI Number | 1518908243
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Entity Type | Individual
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Provider Name | IYAD A ALJABI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 505 KLUTEY PARK PLAZA DR
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City | HENDERSON
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State | KY
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Zip | 42420-5224
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Country | US
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Telephone | 270-830-0313
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Fax | 270-830-7117
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Provider Business Mailing Address
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Address Line | PO BOX 766351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 27411
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License Number State | KY
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