Individual
IMTIAZ HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
306 HOSPITAL DR, SOUTH WILLIAMSON, KY 41503-4095
(606) 237-4943
(606) 237-1740
Mailing address
106 KEENE MANOR CIR, NICHOLASVILLE, KY 40356-7910
(859) 533-1467
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
29223
KY
207RP1001X
Pulmonary Disease Physician
Primary
29223
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000202232
BCBS
—
05
—
0075636000
—
WV
01
—
010721900
FEDERAL BLACK LUNG
—
01
—
1473277
UMWA HEALTH & RETIREMENT
—
01
—
611265801
BRICK STREET ADMINISTRATI
—
05
—
64292238
—
KY
Enumeration date
11/01/2006
Last updated
06/07/2023
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