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NPI Code Detail

MEDICARE: NUSRAT SIDDIQI MD

MEDICARE: NUSRAT SIDDIQI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician37090KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245376896
Entity Type Code : Individual
Provider Name (Legal Business Name) : NUSRAT SIDDIQI MD
Provider Business Mailing Address
First Line : 2400 RUSSELLVILLE RD
Second Line : P.O. BOX 2200
City : HOPKINSVILLE
State : KY
Zip : 42240-8095
Country : US
Telephone Number : 270-889-6025
Fax Number : 270-886-4487
Provider Business Practice Location Address
First Line : 2400 RUSSELLVILLE RD
Second Line :
City : HOPKINSVILLE
State : KY
Zip : 42240-8095
Country : US
Telephone Number : 270-889-6025
Fax Number : 270-886-4487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/08/2007

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Directions to “ NUSRAT SIDDIQI MD” Practice Location

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