Provider Demographics
NPI:1588768261
Name:HUSSAIN, SYED TAUFIQ (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:TAUFIQ
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3406 LONG RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35504-9105
Mailing Address - Country:US
Mailing Address - Phone:205-384-5891
Mailing Address - Fax:
Practice Address - Street 1:3400 HIGHWAY 78 E
Practice Address - Street 2:JASPER PRIMARY CARE CLINIC MEDICAL ART TOWERS SUITE 215
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8907
Practice Address - Country:US
Practice Address - Phone:205-221-7384
Practice Address - Fax:205-221-7385
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALAL19467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine