Organization
PAINTSVILLE PEDIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YASSIN KHATTAB M.D. (PRESIDENT)
(606) 789-5541
Entity
Organization
Contact information
Practice address
822 S MAYO TRL, PAINTSVILLE, KY 41240-1384
(606) 789-5541
(606) 789-9445
Mailing address
822 S MAYO TRL, PAINTSVILLE, KY 41240-1384
(606) 789-5541
(606) 789-9445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203757
ANTHEM BLUE C BLUE S
KY
05
—
31001019
—
KY
Enumeration date
01/16/2007
Last updated
03/25/2013
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