Provider Demographics
NPI:1528001633
Name:BUTT, AHSEN ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:AHSEN
Middle Name:ALI
Last Name:BUTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AHSEN
Other - Middle Name:
Other - Last Name:ALI, MD, PSC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:160 HOSPITAL DR
Mailing Address - Street 2:ARH HOSPITAL
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4071
Mailing Address - Country:US
Mailing Address - Phone:606-237-4800
Mailing Address - Fax:606-237-4803
Practice Address - Street 1:184 S MAYO TRL
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1518
Practice Address - Country:US
Practice Address - Phone:606-430-2213
Practice Address - Fax:606-432-4365
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20250207R00000X
KY31875207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
113278OtherCHA
3519OtherCHA HEALTH INSURANCE
5996190OtherAETNA
KY611396124103A002OtherTRICARE
WV0180532000Medicaid
207518OtherCARELINK
W42188OtherBLUECROSS BLUESHIELD
KY64318751Medicaid
9586OtherBLUEGRASS
001723680OtherMOUNTAIN STATE BLUECROSS
WV002038132003OtherUNITED HEALTHCARE
202554OtherBLACK LUNG
137177OtherUMWA
KY002038132004OtherUNITED HEALTHCARE
WV4054504Medicare PIN
001723680OtherMOUNTAIN STATE BLUECROSS
137177OtherUMWA
110224161Medicare PIN
5996190OtherAETNA
207518OtherCARELINK