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General NPI Number Information
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NPI Number | 1700956844
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Entity Type | Individual
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Provider Name | SHAUKAT ALI M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 1532 LONE OAK RD SUITE 315
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City | PADUCAH
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State | KY
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Zip | 42003-7913
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Country | US
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Telephone | 270-538-5880
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Fax | 270-538-5870
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Provider Business Mailing Address
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Address Line | 1532 LONE OAK RD STE 315
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City | PADUCAH
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State | KY
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Zip | 42003-7942
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Country | US
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Telephone | 270-538-5880
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Fax | 270-538-5870
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 35371
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License Number State | KY
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