Provider Demographics
NPI:1194354621
Name:AHMED, ALI SYED (DPM)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:SYED
Last Name:AHMED
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5412 KILLINUR DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9556
Mailing Address - Country:US
Mailing Address - Phone:502-619-4577
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE STE D135
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-6178
Practice Address - Country:US
Practice Address - Phone:859-323-5533
Practice Address - Fax:859-257-3634
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY284233213ES0103X, 213E00000X
IN07001426A213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist