Individual
IMTIAZ ISMAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 AIRPORT RD STE 301, SULPHUR SPRINGS, TX 75482-2198
(903) 438-8330
Mailing address
100 MEDICAL DR, HANNIBAL, MO 63401-6877
(331) 221-6377
(331) 221-2701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036138972
IL
207RI0011X
Interventional Cardiology Physician
Primary
2021022845
MO
208M00000X
Hospitalist Physician
036138972
IL
Other
Enumeration date
07/18/2013
Last updated
05/09/2025
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