# KHURSHEED SIDDIQUI, MD PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134276744
- **Authorized official:** MR. KHURSHEED A SIDDIQUI MD (GROUP PRESIDENT)
- **Authorized official phone:** (859) 236-9203

## Contact information

- **Practice address:** 300 W BROADWAY ST, DANVILLE, KY 40422-1408
- **Practice address phone:** (859) 236-9203
- **Practice address fax:** (859) 236-6754
- **Mailing address:** PO BOX 7096, STOCKTON, CA 95267-0096
- **Mailing address phone:** (209) 956-7725
- **Mailing address fax:** (209) 956-7733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 08/22/2020