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General NPI Number Information
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NPI Number | 1588753420
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Entity Type | Individual
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Provider Name | KHALID M KHAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 1501 N CAMPBELL AVE UNIVERSITY OF ARIZONA MEDICAL CENTER SUITE 4325F
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City | TUCSON
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State | AZ
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Zip | 85724-5066
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Country | US
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Telephone | 520-626-6211
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Fax | 520-626-9226
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Provider Business Mailing Address
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Address Line | 1501 N CAMPBELL AVE UNIVERSITY OF ARIZONA MEDICAL CENTER SUITE 4325F
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City | TUCSON
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State | AZ
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Zip | 85724-5066
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Country | US
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Telephone | 520-626-6211
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Fax | 520-626-9226
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 40430
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License Number State | AZ
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