Provider Demographics
NPI:1285871525
Name:ASAD ISMAIL PSYCHYTRY NEUROLOGY SERVICES, PSC
Entity type:Organization
Organization Name:ASAD ISMAIL PSYCHYTRY NEUROLOGY SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ASAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-532-2905
Mailing Address - Street 1:10210 SPRINGHURST GARDEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241
Mailing Address - Country:US
Mailing Address - Phone:800-532-2905
Mailing Address - Fax:859-291-9101
Practice Address - Street 1:10210 SPRINGHURST GARDEN CIRCLE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241
Practice Address - Country:US
Practice Address - Phone:800-532-2905
Practice Address - Fax:859-291-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty