Individual
MOHAMMAD JAVAD IQBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 WOODLAND DRIVE SUITE 110, ELIZABETHTOWN, KY 42701
(270) 769-3631
(270) 769-3996
Mailing address
PO BOX 2636, ELIZABETHTOWN, KY 42702-2636
(270) 769-3631
(270) 769-3996
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
18016
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045927
ANTHEM
—
01
—
50000419
PASSPORT
—
05
—
64180169
—
KY
Enumeration date
03/30/2006
Last updated
07/01/2010
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