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General NPI Number Information
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NPI Number | 1932193687
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Entity Type | Individual
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Provider Name | IQTIDAR A KHAN M D
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 302 BILL CLINTON DR SUITE 103
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City | HOPE
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State | AR
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Zip | 71801-8661
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Country | US
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Telephone | 870-777-2970
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Fax | 870-722-6619
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Provider Business Mailing Address
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Address Line | 302 BILL CLINTON DR SUITE 103
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City | HOPE
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State | AR
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Zip | 71801-8661
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Country | US
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Telephone | 870-777-2970
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Fax | 870-722-6619
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01072120A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E2934
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L9762
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD445904
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 29405
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License Number State | WV
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