Organization
MOHAMMAD J. IQBAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD JAVAD IQBAL MD (OWNER)
(270) 769-3631
Entity
Organization
Contact information
Practice address
1230 WOODLAND DR, SUITE 110, ELIZABETHTOWN, KY 42701-2766
(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 KY
KY
01
—
1049089
PASSPORT
KY
05
—
64180169
—
KY
Enumeration date
05/14/2008
Last updated
05/15/2008
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