Individual
ALI R KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13395 N MARANA MAIN ST, MARANA, AZ 85653-7008
(520) 682-4111
(520) 682-3817
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
003975
GA
207Q00000X
Family Medicine Physician
Primary
45692
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
716399
—
AZ
Enumeration date
02/06/2010
Last updated
07/20/2015
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