Healthcare Provider Details

I. General information

NPI: 1265405286
Provider Name (Legal Business Name): MISAL KHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 E HIGHWAY 98
PANAMA CITY FL
32401-5415
US

IV. Provider business mailing address

3141 E HIGHWAY 98
PANAMA CITY FL
32401-5415
US

V. Phone/Fax

Practice location:
  • Phone: 850-785-9511
  • Fax:
Mailing address:
  • Phone: 850-785-9511
  • Fax: 850-763-9494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME32811
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME32811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: