MEDICARE: DR. ZUBAIR ASIF KHAN O.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	152W00000X	Optometrist	18003265A	IN

General Provider Information

NPI Number	:	1669547048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZUBAIR ASIF KHAN O.D.

Provider Business Mailing Address
First Line	:	9209 NORWICH CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1111
Country	:	US
Telephone Number	:	260-490-8287
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 E COLISEUM BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-1215
Country	:	US
Telephone Number	:	260-373-2033
Fax Number	:

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/12/2021

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