Madad Ali, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

2002027101 Issued in MO

Legal business name

MADAD ALI, MD

Practice address

2520 Lucy Lee Pkwy
Poplar Bluff, MO 63901-2436

Phone

(573) 785-7475

Fax

(573) 785-6555

NPI assigned

Mar 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Madad Ali, MDNPI 1376564815

Title

Physician

Phone

(573) 785-7475

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alfa Digestive Disease Center Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madad Ali, M.D.

  • Gastroenterology Physician
  • Harvey, IL
  • NPI 1376564815
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1336310838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020216",
            "telephone_number": "573-785-7475",
            "fax_number": "573-785-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 LUCY LEE PKWY",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012436",
            "telephone_number": "573-785-7475",
            "fax_number": "573-785-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADAD ALI, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "MADAD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "573-785-7475",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2002027101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2060127010",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alfa Digestive Disease Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karlie Ann Lyscas
• Lydia Alpha Mabbitt, LPC
• Daron Knol Mackinder, BAS
• Betty Macleod, RN
• Virginia J Maclin, A.P.N.
• Sivaprasad D Madduri, MD
• Linda D. Magruder, LPC
• Karan Mahal
• Lance T Majors, MD
• Ashley Malkowski, PHARMD

• Gastroenterology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.