Organization
J. KHAN, LLC
Active
Organization
J. KHAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKULLA KHAN M.D. (OWNER)
(928) 681-8671
Entity
Organization
Contact information
Practice address
1739 E BEVERLY AVE, SUITE 221, KINGMAN, AZ 86409-3593
(928) 681-8671
(928) 681-8672
Mailing address
1739 E BEVERLY AVE, SUITE 221, KINGMAN, AZ 86409-3593
(928) 681-8671
(928) 681-8672
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
37755
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37755
AZ MEDICAL LICENSE
AZ
Enumeration date
06/16/2008
Last updated
03/07/2023
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