Individual
HAFIZ KHATTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7491 BIG BEND BLVD, WEBSTER GROVES, MO 63119-2101
(314) 961-3038
(618) 398-6266
Mailing address
PO BOX 2153 DEPT 30703, BIRMINGHAM, AL 35287-9256
(314) 961-3038
(314) 961-6731
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036101887
IL
208100000X
Physical Medicine & Rehabilitation Physician
2000161127
MO
208VP0000X
Pain Medicine Physician
Primary
2000161127
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205739006
—
MO
Enumeration date
12/28/2005
Last updated
02/23/2024
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