| Ahmad Tariq Ismail | |
|
110 E Byrd Ave Bonifay FL 32425-3004 | |
| (850) 547-4799 | |
| (850) 547-2305 |
| Full Name | Ahmad Tariq Ismail |
|---|---|
| Speciality | Family Medicine |
| Location | 110 E Byrd Ave, Bonifay, Florida |
| Authorized Official Name and Position | Carol L Curry (OFFICE MANAGER) |
| Authorized Official Contact | 8505474799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahmad Tariq Ismail 110 E Byrd Ave Bonifay FL 32425-3004 Ph: (850) 547-4799 | Ahmad Tariq Ismail 110 E Byrd Ave Bonifay FL 32425-3004 Ph: (850) 547-4799 |
| NPI Number | 1952697575 |
|---|---|
| Provider Enumeration Date | 06/22/2011 |
| Last Update Date | 06/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952697575 | NPI | - | NPPES |
| 66005600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME44907 (Florida) | Primary |
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