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General NPI Number Information
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NPI Number | 1720393077
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Entity Type | Individual
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Provider Name | LAITH KHOURY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5838 SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27609-3885
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Country | US
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Telephone | 919-785-3400
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Fax | 919-783-7778
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Provider Business Mailing Address
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Address Line | 5838 SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27609-3885
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Country | US
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Telephone | 919-785-3400
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Fax | 919-783-7778
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | R2513
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License Number State | KY
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