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General NPI Number Information
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NPI Number | 1609045848
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Entity Type | Organization
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Legal Business Name | NECKLALL KHOOBLALL MD INC
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 253 S CANFIELD NILES RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-4082
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Country | US
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Telephone | 330-792-9630
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Fax |
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Provider Business Mailing Address
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Address Line | 253 S CANFIELD NILES RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-4082
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Country | US
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Telephone | 330-792-9630
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. NECKLALL I KHOOBLALL
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Credential | MD
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Telephone | 330-792-9630
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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 | 61266
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License Number State | OH
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