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General NPI Number Information
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NPI Number | 1194919159
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Entity Type | Individual
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Provider Name | ABBAS ALI KHAWARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 1 AUDUBON PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40217-1318
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Country | US
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Telephone | 502-742-7062
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 950137
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City | LOUISVILLE
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State | KY
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Zip | 40295-0137
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1066082A
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License Number State | IN
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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 | 40695
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License Number State | KY
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