Provider Demographics
NPI:1710656020
Name:AHSEN ALI MD PSC
Entity Type:Organization
Organization Name:AHSEN ALI MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHSEN
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:BUTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-237-4800
Mailing Address - Street 1:160 HOSPITAL DR
Mailing Address - Street 2:
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 1:306 HOSPITAL DR STE 2C
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4095
Practice Address - Country:US
Practice Address - Phone:606-237-4800
Practice Address - Fax:606-237-4803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health