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Individual

OSAMA ALI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
204 BEVINS LN STE A, GEORGETOWN, KY 40324-6145
(502) 603-9881
(888) 234-8154
Mailing address
222 S 3RD ST, DANVILLE, KY 40422-1824
(859) 239-5570

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
121075
OH
2084P0800X
Psychiatry Physician
Primary
47019
KY
2084P0802X
Addiction Psychiatry Physician
121075
OH
2084P0802X
Addiction Psychiatry Physician
47019
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100303280
KY
Enumeration date
04/01/2010
Last updated
03/15/2019
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