MEDICARE: DR. JOSEF KHALIL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	36157	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356403695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEF KHALIL M.D.

Provider Business Mailing Address
First Line	:	1002 E. MCDOWELL RD.
Second Line	:	SUITE A
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2624
Country	:	US
Telephone Number	:	602-388-4299
Fax Number	:	602-388-4097

Provider Business Practice Location Address
First Line	:	1002 E. MCDOWELL RD.
Second Line	:	SUITE A
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2624
Country	:	US
Telephone Number	:	602-388-4299
Fax Number	:	602-388-4097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	05/04/2017

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