Healthcare Provider Details

I. General information

NPI: 1003967977
Provider Name (Legal Business Name): IQBAL AKHTAR YAR KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 UNION AVE SUITE 2800
MOBERLY MO
65270-9402
US

IV. Provider business mailing address

1513 UNION AVE SUITE 2800
MOBERLY MO
65270-9402
US

V. Phone/Fax

Practice location:
  • Phone: 660-263-4434
  • Fax: 660-263-4436
Mailing address:
  • Phone: 660-263-4434
  • Fax: 660-263-4436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number113667
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number113667
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number113667
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: