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General NPI Number Information
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NPI Number | 1245544998
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Entity Type | Individual
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Provider Name | KHALIL I. SOBOH M.D
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Gender | Male
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2001 W 86TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1902
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Country | US
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Telephone | 317-338-2345
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Fax | 317-583-3099
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Provider Business Mailing Address
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Address Line | PO BOX 23229
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City | OWENSBORO
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State | KY
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Zip | 42304-3229
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Country | US
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Telephone | 270-691-8070
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Fax | 270-691-8026
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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 | 01081174A
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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 | 45940
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 242879
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License Number State | MA
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