Provider Demographics
NPI:1902987431
Name:SHIKHTHOLTH, AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:SHIKHTHOLTH
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:PO BOX 5038
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-0038
Mailing Address - Country:US
Mailing Address - Phone:256-301-9994
Mailing Address - Fax:256-301-5545
Practice Address - Street 1:2208 DANVILLE RD SW
Practice Address - Street 2:SUITE G
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4603
Practice Address - Country:US
Practice Address - Phone:256-301-9994
Practice Address - Fax:256-301-5545
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27458207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL273505557OtherTAX ID, AHMAD SHIKHTHOLTH
AL273505557OtherTAX ID, AHMAD SHIKHTHOLTH