Healthcare Provider Details

I. General information

NPI: 1922077841
Provider Name (Legal Business Name): BIBI S KHOYRATTY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

IV. Provider business mailing address

785 5TH AVE STE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 515-247-3100
  • Fax:
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-709-6529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number43188
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0101282343
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD454133
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD454133
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: