# KHATIB FAMILY PRACTICE PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528251667
- **Authorized official:** MRS. SUSAN KHATIB (OFFICE MANAGER)
- **Authorized official phone:** (928) 763-9009

## Contact information

- **Practice address:** 2755 SILVER CREEK RD, SUITE 109, BULLHEAD CITY, AZ 86442-7904
- **Practice address phone:** (928) 763-9009
- **Practice address fax:** (928) 763-9292
- **Mailing address:** PO BOX 20758, BULLHEAD CITY, AZ 86439-0758
- **Mailing address phone:** (928) 763-9009
- **Mailing address fax:** (928) 763-9292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 26804 | AZ | Yes |

## Other

- **Enumeration date:** 08/22/2007
- **Last updated:** 12/18/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 434572001 | — | AZ |