Individual
DR. IJAZ MAHMOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1239 WOODLAND DR, SUITE 105, ELIZABETHTOWN, KY 42701-2770
(270) 900-1461
(270) 900-1468
Mailing address
1239 WOODLAND DR, SUITE 105, ELIZABETHTOWN, KY 42701-2770
(270) 900-1461
(270) 900-1468
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
31150
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1048927
PASSPORT
KY
05
—
64311509
—
KY
Enumeration date
11/16/2005
Last updated
05/22/2015
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