Individual
DR. JAKAULLA KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1003 MAIN AVE, CLIFTON, NJ 07011-2333
(973) 777-9595
Mailing address
1739 E BEVERLY AVE, STE 208, KINGMAN, AZ 86409-3593
(201) 512-9494
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
37755
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6707301
—
NJ
Enumeration date
10/13/2006
Last updated
10/19/2016
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