Individual
YAQOOB KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 OAK GROVE RD, POPLAR BLUFF, MO 63901-1573
(573) 776-9752
(573) 776-9027
Mailing address
3100 OAK GROVE RD, POPLAR BLUFF, MO 63901-1573
(573) 776-9752
(573) 776-9027
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2023019467
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2023
Last updated
05/26/2023
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