| Siraj Siddiqi M.d Pllc | |
|
1019 Commerce Pkwy Lagrange KY 40031-8779 | |
| (502) 225-9098 | |
| (502) 225-9851 |
| Full Name | Siraj Siddiqi M.d Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1019 Commerce Pkwy, Lagrange, Kentucky |
| Authorized Official Name and Position | Siraj U Siddiqi (OWNER) |
| Authorized Official Contact | 5022259098 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siraj Siddiqi M.d Pllc 1019 Commerce Pkwy Lagrange KY 40031-8779 Ph: (502) 225-9098 | Siraj Siddiqi M.d Pllc 1019 Commerce Pkwy Lagrange KY 40031-8779 Ph: (502) 225-9098 |
| NPI Number | 1578686762 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 01/23/2018 |
| Medicare PECOS PAC ID | 4183908957 |
|---|---|
| Medicare Enrollment ID | O20170223001442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578686762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 28062 (Kentucky) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Siraj U Siddiqi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912056318 PECOS PAC ID: 6901895390 Enrollment ID: I20170223001570 |
Madonna Ringswald Do Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1031 New Moody Ln, Suite 301, Lagrange, KY 40031 Phone: 502-222-1545 Fax: 502-222-1679 | |
Marcia D. Ebbs Md Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1009 New Moody Ln, Suite 4, Lagrange, KY 40031 Phone: 502-222-3927 | |
Ann E Roberts Md Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1031 New Moody Lane, Ste 200, Lagrange, KY 40031 Phone: 502-222-3312 Fax: 502-222-2217 |