Organization
E TOWN LUNG SPECIALIST PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIJAZ A YAZDANI MD (MEDICAL DOCTOR)
(270) 735-9066
Entity
Organization
Contact information
Practice address
914 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2520
(270) 735-9066
(270) 735-9036
Mailing address
914 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2520
(270) 735-9066
(270) 735-9036
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290014995
RAILROAD MEDICARE
—
05
—
64328784
—
KY
Enumeration date
08/12/2006
Last updated
08/11/2025
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