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General NPI Number Information
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NPI Number | 1093812612
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Entity Type | Organization
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Legal Business Name | ASTHMA AND ALLERGY CLINIC, P.A.
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 2687 JENKS AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4351
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Country | US
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Telephone | 850-747-3665
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Fax |
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Provider Business Mailing Address
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Address Line | 2687 JENKS AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4351
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Country | US
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Telephone | 850-747-3665
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEETA KHARE
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Credential | M.D.
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Telephone | 850-747-3665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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