Individual
DR. BASEL KHOURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(740) 395-8805
(740) 395-8855
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5890
(740) 446-5532
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-08-5785
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181848
UNISON MEDICAID
OH
01
—
000000370742
ANTHEM BCBS
—
01
—
001770630
MOUNTAIN STATE BCBS
—
01
—
1306893847
NPI
—
01
—
2605569
MOLINA MEDICAID
OH
05
—
3810002963
—
WV
01
—
P00274238
RR MEDICARE
—
Enumeration date
05/30/2006
Last updated
08/30/2007
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