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General NPI Number Information
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NPI Number | 1164445417
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Entity Type | Individual
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Provider Name | JEHANZEB KHAN MBBS
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1321 RING RD SUITE 105
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-8940
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Country | US
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Telephone | 270-986-7372
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 505673
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City | SAINT LOUIS
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State | MO
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Zip | 63150-5673
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2025005270
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | ME94876
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 40954
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License Number State | KY
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