Individual
DR. AHMAD KHATTAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
802 S JACKSON AVE STE 410, TULSA, OK 74127-9059
(918) 631-8202
(918) 631-8204
Mailing address
744 W 9TH ST, TULSA, OK 74127-9020
(918) 561-5701
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
6580
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200844910A
—
OK
01
—
830031
MEDICARE
OK
Enumeration date
04/28/2014
Last updated
10/19/2021
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