Provider Demographics
NPI:1558519744
Name:TAUQIR AHMAD, M.D., P.L.L.C.
Entity Type:Organization
Organization Name:TAUQIR AHMAD, M.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAUQIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-845-5959
Mailing Address - Street 1:PO BOX 23187
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85063-3187
Mailing Address - Country:US
Mailing Address - Phone:623-845-5959
Mailing Address - Fax:623-845-6013
Practice Address - Street 1:9150 W INDIAN SCHOOL RD
Practice Address - Street 2:UNIT 8, STE 131
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-2384
Practice Address - Country:US
Practice Address - Phone:623-845-5959
Practice Address - Fax:623-845-6013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-31
Last Update Date:2008-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29723207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ701559Medicaid
AZ701559Medicaid