Individual
KHALID A KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 MEDICAL PARK DR, SHAWNEE, OK 74804-5014
(405) 878-9490
(405) 878-9492
Mailing address
PO BOX 14459, OKLAHOMA CITY, OK 73113-0459
(405) 775-9350
(405) 775-9360
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
19113
OK
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
19113
OK
208VP0000X
Pain Medicine Physician
19113
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00474293
MEDICARE RR
OK
Enumeration date
03/10/2006
Last updated
03/14/2014
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