Organization
DASTAGIR A KHAN MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DASTAGIR KHAN M.D. (PHYSICIAN)
(904) 955-7190
Entity
Organization
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 955-7190
Mailing address
207 BARONY DR, JACKSONVILLE, FL 32225-6119
(904) 955-7190
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
ARNP9264398
FL
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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