Individual
DR. KHALED MUSTAFA GHORAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 S 6TH ST, LEESVILLE, LA 71446-4719
(337) 238-6161
(337) 238-0085
Mailing address
700 S 6TH ST, LEESVILLE, LA 71446-4719
(337) 238-6161
(337) 238-0085
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
202557
LA
208600000X
Surgery Physician
C7-0003294
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202557
LA LIC#
LA
Enumeration date
03/15/2007
Last updated
07/15/2013
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