Individual
DR. KENNETH GEORGE KHATAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1108
(208) 422-1241
Mailing address
6168 S SCHOONER PL, BOISE, ID 83716-9084
(208) 422-1108
(208) 422-1241
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M6592
ID
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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