Healthcare Provider Details

I. General information

NPI: 1760601561
Provider Name (Legal Business Name): RAMZI WILLIAM KHAZEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 LEGATE HILL RD
LEOMINSTER MA
01453-5260
US

IV. Provider business mailing address

319 LEGATE HILL RD
LEOMINSTER MA
01453-5260
US

V. Phone/Fax

Practice location:
  • Phone: 316-680-6030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number234869
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: