Individual
KHAN MATIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3701 LANSDOWNE DR, ASHLAND, KY 41101
(606) 324-3005
(606) 329-1530
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22483
KY
2084P0800X
Psychiatry Physician
35050198
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
05
—
0114374000
—
WV
01
—
0519303
MEDICARE PTAN # - PATHWAYS, INC.
KY
05
—
0806677
—
OH
01
—
11101867
CAQH
—
01
—
1669101
INDIVIDUAL MEDICARE PTAN
KY
01
—
1982615043
PATHWAYS GROUP NPI #
KY
01
—
260031769
PALMETTO GPA RR MEDICARE
—
05
—
30610026
—
KY
01
—
3402033
ASHLAND HOSPITAL CORP (KDMC) MEDICARE PTAN
KY
05
—
64224835
—
KY
Enumeration date
07/30/2006
Last updated
11/07/2014
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