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Individual

YEHIA A. KHOGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5686
(608) 363-5756
Mailing address
1969 W HART RD, BELOIT, WI 53511-2230
(608) 364-5686
(608) 363-5756

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036090712
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
63732-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100043967
WI
Enumeration date
10/06/2005
Last updated
03/21/2018
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