Provider Demographics
NPI:1417921545
Name:FAROOQUI, JAMIL A (MD)
Entity Type:Individual
Prefix:
First Name:JAMIL
Middle Name:A
Last Name:FAROOQUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:SUITE A-510
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-258-6784
Mailing Address - Fax:859-258-6796
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:SUITE A-510
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-258-6784
Practice Address - Fax:859-258-6796
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY36527207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY030670000OtherBLACK LUNG
KY4000501OtherMEDICARE LAB GROUP
KY611427889OtherTRICARE
KY64037518Medicaid
KY50006184OtherPASSPORT HEALTH PLAN
KY611427889OtherCHA
KYC72825OtherCUMBERLAND HEALTHCARE INC
KY000000377982OtherANTHEM
KY36000818OtherMEDICAID LAB GROUP
KYP00316601OtherRAILROAD MEDICARE
KY611427889OtherBLUEGRASS FAMILY HEALTH
KYCB5773OtherRR MEDICARE GROUP
KY611427889OtherUHC
KY611427889OtherHUMANA
KYCB5773OtherRR MEDICARE GROUP
KY030670000OtherBLACK LUNG
KY0626732Medicare ID - Type Unspecified
KYH41334Medicare UPIN