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Individual

TAIF KHATTAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4 SHERIDAN SQ STE 200, KINGSPORT, TN 37660-7435
(423) 246-7931
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
74049
TN
208M00000X
Hospitalist Physician
Primary
74049
TN
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679208078
VA
05
Q076331
TN
Enumeration date
07/19/2022
Last updated
02/04/2026
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