Organization
ADVANCED FAMILY MEDICAL CLINIC LIBERTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHURSHEED AKRAM SIDDIQUI MD (MEDICAL DIRECTOR)
(859) 691-0201
Entity
Organization
Contact information
Practice address
84 HUSTONVILLE ST, LIBERTY, KY 42539-3469
(606) 706-7473
(606) 303-9170
Mailing address
PO BOX 2369, DANVILLE, KY 40423-2369
(606) 303-9011
(606) 303-9170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28741
KY
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65942906
—
KY
05
—
7100503210
—
KY
Enumeration date
05/18/2017
Last updated
01/16/2026
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