Individual
MR. KHURSHEED A SIDDIQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 WEST BROADWAY, DANVILLE, KY 40422-1408
(859) 236-0606
(859) 236-0066
Mailing address
300 WEST BROADWAY, DANVILLE, KY 40422-1408
(859) 236-0606
(859) 236-0066
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
28741
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
28741
KY
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
28741
KY
208VP0000X
Pain Medicine Physician
Primary
28741
KY
208VP0014X
Interventional Pain Medicine Physician
28741
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64287410
—
KY
Enumeration date
06/06/2006
Last updated
12/16/2021
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