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Organization

HOUSAM I HADDAD MEDICAL PRACTICE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HOUSAM I HADDAD MD (OWNER)
(859) 327-7283
Entity
Organization

Contact information

Practice address
187 WOLFORD AVE, LIBERTY, KY 42539-3278
(859) 327-7283
(800) 591-6398
Mailing address
PO BOX 1519, LIBERTY, KY 42539-1519
(859) 327-7283
(606) 787-0251

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31531
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64315310
KY
Enumeration date
03/15/2012
Last updated
12/21/2016
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