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General NPI Number Information
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NPI Number | 1629461751
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Entity Type | Organization
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Legal Business Name | CENTRAL MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 1311 RING RD STE 103
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701
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Country | US
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Telephone | 270-735-1690
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 RING ROAD STE 105
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701
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Country | US
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Telephone | 270-986-7373
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Fax |
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Authorized Official
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Title or Position | MEMEBER
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Name | DR. SYED R QUADRI
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Credential | MD
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Telephone | 270-723-4772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34388
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License Number State | KY
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