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General NPI Number Information
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NPI Number | 1407075021
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Entity Type | Individual
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Provider Name | MITCHELL ALAN KHAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 410 E ROBINSON ST SUITE B2
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City | KNOXVILLE
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State | IA
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Zip | 50138-2058
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Country | US
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Telephone | 641-842-3700
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Fax | 641-842-3363
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Provider Business Mailing Address
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Address Line | 410 E ROBINSON ST SUITE B2
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City | KNOXVILLE
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State | IA
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Zip | 50138-2058
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Country | US
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Telephone | 641-842-3700
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Fax | 641-842-3363
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036113101
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 3794
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License Number State | IA
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