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General NPI Number Information
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NPI Number | 1134322498
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Entity Type | Individual
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Provider Name | HARRIS KHAN KHAKWANI MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 3540 E BASELINE RD 130
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City | PHOENIX
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State | AZ
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Zip | 85042-9627
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Country | US
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Telephone | 623-251-7559
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Fax | 623-266-4012
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Provider Business Mailing Address
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Address Line | PO BOX 660047
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City | DALLAS
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State | TX
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Zip | 75266-2900
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Country | US
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Telephone | 602-633-3848
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Fax | 602-633-3841
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42338
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License Number State | AZ
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