Individual
DR. KHALID JALIL MANZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W 5TH ST, STE 100, LONDON, KY 40741-2112
(606) 864-4040
(606) 864-3500
Mailing address
PO BOX 73652, CLEVELAND, OH 44193-0002
(859) 313-2758
(859) 276-5939
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
34308
IA
207RI0011X
Interventional Cardiology Physician
Primary
MD457745
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0247221
—
IA
01
—
060067839
RAILROAD MEDICARE
—
01
—
071725
HEALTH ALLIANCE
—
01
—
235475
MIDLANDS CHOICE
—
01
—
43330
WELLMARK BC/BS
—
01
—
67134
IOWA HEALTH SOLUTIONS
—
01
—
IA0193
JOHN DEERE HEALTH
—
Enumeration date
04/27/2006
Last updated
04/29/2016
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