Healthcare Provider Details

I. General information

NPI: 1790149037
Provider Name (Legal Business Name): JAMIL KHOURI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7337 CARITAS CIR NW STE 270
MASSILLON OH
44646-9126
US

IV. Provider business mailing address

7337 CARITAS CIR NW STE 270
MASSILLON OH
44646-9126
US

V. Phone/Fax

Practice location:
  • Phone: 133-048-9136
  • Fax:
Mailing address:
  • Phone: 133-048-9136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.135055
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: