Provider Demographics
NPI:1790856144
Name:KAZI, ABDUL AHAD (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:AHAD
Last Name:KAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 LEIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5786
Mailing Address - Country:US
Mailing Address - Phone:256-237-6769
Mailing Address - Fax:256-237-6719
Practice Address - Street 1:822 LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5786
Practice Address - Country:US
Practice Address - Phone:256-237-6769
Practice Address - Fax:256-237-6719
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026028207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009937389Medicaid