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General NPI Number Information
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NPI Number | 1154490282
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Entity Type | Individual
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Provider Name | NABEEL HASAN KHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 9140 HIGHWAY 51 N
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City | SOUTHAVEN
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State | MS
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Zip | 38671-1233
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Country | US
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Telephone | 662-280-8222
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Fax | 662-280-5541
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Provider Business Mailing Address
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Address Line | 1430 TULANE AVE # TW22
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2632
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Country | US
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Telephone | 504-988-2300
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 13646-R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD480004
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License Number State | PA
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