Organization
KHATIB FAMILY PRACTICE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN KHATIB (OFFICE MANAGER)
(928) 763-9009
Entity
Organization
Contact information
Practice address
2755 SILVER CREEK RD, SUITE 109, BULLHEAD CITY, AZ 86442-7904
(928) 763-9009
(928) 763-9292
Mailing address
PO BOX 20758, BULLHEAD CITY, AZ 86439-0758
(928) 763-9009
(928) 763-9292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26804
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434572001
—
AZ
Enumeration date
08/22/2007
Last updated
12/18/2007
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