Organization
UNIVERSITY OF LOUISVILLE
Active
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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