Basic Information
| Provider Information | |||||||||
| NPI: | 1891936043 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALI FAMILY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 740 E LAUREL RD | ||||||||
| Address2: | |||||||||
| City: | LONDON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 407418601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063303404 | ||||||||
| FaxNumber: | 6063303100 | ||||||||
| Practice Location | |||||||||
| Address1: | 192 LONDON SHOPPING CTR | ||||||||
| Address2: | STE 2 | ||||||||
| City: | LONDON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 407413015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6068776050 | ||||||||
| FaxNumber: | 6068772136 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2009 | ||||||||
| LastUpdateDate: | 03/18/2009 | ||||||||
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| AuthorizedOfficialLastName: | ALI | ||||||||
| AuthorizedOfficialFirstName: | AMJAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6063303404 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 34288 | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.