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General NPI Number Information
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NPI Number | 1538535737
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Entity Type | Individual
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Provider Name | EESHA KHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 1800 12TH ST
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City | MERIDIAN
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State | MS
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Zip | 39301-4158
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Country | US
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Telephone | 601-703-6700
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Fax | 601-703-3024
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Provider Business Mailing Address
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Address Line | PO BOX 5392
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City | MERIDIAN
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State | MS
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Zip | 39302-5392
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Country | US
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Telephone | 601-703-4379
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Fax | 601-703-9283
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 263508
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 30431
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License Number State | MS
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