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Individual

DR. FAROOQ A MIRZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3799
(502) 732-8551
Mailing address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3799
(502) 732-8551

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20006
KY
208600000X
Surgery Physician
44235
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20006
STATE LICENSE NUMBER
KY
05
64866247
KY
Enumeration date
07/19/2006
Last updated
09/24/2021
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