Individual
KHALID H MEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
378 THOMPSON POYNTER RD, LONDON, KY 40741-7238
(606) 877-3990
(606) 877-3993
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 877-3978
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35415
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000377916
ANTHEM PROVIDER #
KY
01
—
030670000
BLACK LUNG
KY
01
—
50005619
PASSPORT HEALTH PLAN
KY
01
—
61-1427889
TRICARE
KY
05
—
64007297
—
KY
01
—
C12865
CUMBERLAND HEALTHCARE INC
KY
Enumeration date
02/15/2006
Last updated
05/06/2019
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