Provider Demographics
NPI:1003224809
Name:AHMAD, BILAL (OD)
Entity Type:Individual
Prefix:
First Name:BILAL
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 BRIAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40516-9719
Mailing Address - Country:US
Mailing Address - Phone:859-433-1964
Mailing Address - Fax:
Practice Address - Street 1:4140 BRIAR HILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40516-9719
Practice Address - Country:US
Practice Address - Phone:859-433-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1951DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist