Individual
NUSRAT J KHANSUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1551 W GOVERNMENT ST, BRANDON, MS 39042-2408
(601) 825-3163
(601) 825-7893
Mailing address
PO BOX 6227, PEARL, MS 39288-6227
(601) 825-7280
(601) 825-8130
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11118
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116487
—
MS
Enumeration date
07/12/2006
Last updated
07/08/2007
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