Individual
PROF. ZAFRULLA KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.M.S.
Contact information
Practice address
529 S JACKSON ST, BROWN CANCER CENTER STE 127, LOUISVILLE, KY 40202-3229
(502) 852-5747
(502) 852-6132
Mailing address
529 S JACKSON ST, BROWN CANCER CENTER STE 127, LOUISVILLE, KY 40202-3229
(502) 852-5747
(502) 852-6132
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
5067
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
5067/500
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003831
PASSPORT
KY
01
—
100018200
INDIANA MEDICAID
IN
01
—
190005666
RR MEDICARE
KY
01
—
2437178000
PASSPORT ADVANTAGE
KY
01
—
5651497
AETNA
KY
05
—
60050671
—
KY
01
—
611014882
UNITED HEALTH CARE
KY
01
—
611014882002
HEALTH NET TRICARE
KY
01
—
775656
UNITED CONN
KY
Enumeration date
03/14/2006
Last updated
09/13/2018
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