Organization
HOUSAM I HADDAD MEDICAL PRACTICE, PLLC
Active
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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