Organization
UNIVERSITY OF LOUISVILLE
Active
Other names
Maxillofacial Oncologic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZAFRULLA KHAN DDS (PROSTHODONTICS)
(502) 852-5747
Entity
Organization
Contact information
Practice address
529 S JACKSON ST, # 127, LOUISVILLE, KY 40202-3229
(502) 852-5747
(502) 852-6132
Mailing address
529 S JACKSON ST, # 127, LOUISVILLE, KY 40202-3229
(502) 852-5747
(502) 852-6132
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175275
ANTHEM BCBS
KY
01
—
0003831
PASSPORT
KY
01
—
100018200
INDIANA MEDICAID
IN
01
—
190005666
RR MEDICARE
KY
01
—
2438647000
PASSPORT ADVANTAGE
KY
01
—
5651497
AETNA
KY
05
—
60050671
—
KY
01
—
775656
UNITED CONN
KY
Enumeration date
03/16/2007
Last updated
09/21/2009
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