ISMAIL, ASAD E (MD)

Provider Demographics

• NPI: 1144227026
• Name: ISMAIL, ASAD E (MD)
• Entity Type: Individual
• First Name: ASAD
• Middle Name: E
• Last Name: ISMAIL
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 720 W BROADWAY STE 202
• Mailing Address - City: LOUISVILLE
• Mailing Address - State: KY
• Mailing Address - Zip Code: 40202-3245
• Mailing Address - Country: US
• Mailing Address - Phone: 502-561-0943
• Mailing Address - Fax: 502-561-0944
• Practice Address - Street 1: 645 S ROY WILKINS AVE STE 200
• Practice Address - City: LOUISVILLE
• Practice Address - State: KY
• Practice Address - Zip Code: 40203-2072
• Practice Address - Country: US
• Practice Address - Phone: 502-561-0520
• Practice Address - Fax: 502-653-8181
• Is Sole Proprietor?: No
• Enumeration Date: 2005-07-07
• Last Update Date: 2021-11-08

Provider Licenses

State	License ID	Taxonomies
IN	01050254A	2084N0400X, 2084P0800X, 2084A0401X
KY	34174	2084P0800X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2084A0401X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Addiction Medicine
No	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Neurology
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry

Provider Identifiers

State	Identifier ID	ID Type	Issuer
KY	2444451000	Other	PASSPORT GROUP
KY	78903689	Medicaid
IN	CG3623	Other	RAILROAD MEDICARE GROUP
IN	P00127309	Other	MEDICARE RAILROAD
	000000056294	Other	ANTHEM GROUP
	000000328529	Other	ANTHEM
KY	6764	Other	MEDICARE GROUP
IN	160860	Other	MEDICARE GROUP
KY	CK2274	Other	RAILROAD MEDICARE GROUP
KY	130025311	Other	MEDICARE RAILROAD
KY	65927857	Medicaid
	1063415297	Other	GROUP NPI
IN	160780	Other	MEDICARE GROUP
IN	200244600A	Medicaid
	214446000	Other	MAGELLAN MIS
KY	2699709000	Other	PASSPORT ADVANTAGE
KY	64342744	Medicaid
IN	100386460	Other	MEDICAID GROUP
	50704000	Other	MAGELLAN MIS
KY	82900176	Medicaid
IN	P00127309	Other	MEDICARE RAILROAD
KY	64342744	Medicaid
KY	82900176	Medicaid