Organization
ADVANCED FAMILY MEDICAL CLINIC LIBERTY
Active
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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