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NPI Code Detail

MEDICARE: DR. SIDRA KHALID KHAN MD

MEDICARE: DR. SIDRA KHALID KHAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramAZ

General Provider Information

NPI Number : 1023957420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIDRA KHALID KHAN MD
Provider Business Mailing Address
First Line : 5301 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-2874
Country : US
Telephone Number : 520-324-5095
Fax Number :
Provider Business Practice Location Address
First Line : 5301 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-2874
Country : US
Telephone Number : 520-327-5461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2026
Last Update Date : 03/28/2026

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