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General NPI Number Information
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NPI Number | 1912331323
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Entity Type | Individual
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Provider Name | ABDUL HASAN SIDDIQUI M.D
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Gender | Male
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 09/03/2021
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Provider Practice Location Address
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Address Line | 1025 SAINT JOSEPH LN
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City | LONDON
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State | KY
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Zip | 40741-8345
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Country | US
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Telephone | 606-864-4030
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Fax | 606-864-0115
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | LONDON
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State | KY
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Zip | 40743-0936
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Country | US
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Telephone |
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Fax | 606-330-7825
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036-148564
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License Number State | IL
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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 | 287538
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License Number State | NY
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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 | 036-148564
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 55387
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License Number State | KY
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