Individual
DR. FARHOUD KHOSRAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2490 S WOODWORTH LOOP STE 200, PALMER, AK 99645-7410
(907) 861-6315
Mailing address
2680 S VAL VISTA DR, GILBERT, AZ 85295-2152
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02003720A
IN
207R00000X
Internal Medicine Physician
DO-04549
IA
207RG0100X
Gastroenterology Physician
006861
AZ
207RG0100X
Gastroenterology Physician
Primary
206386
AK
Other
Enumeration date
03/02/2009
Last updated
09/15/2023
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