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NPI Code Detail

MEDICARE: DR. HAKAM KHAZRIK MD

MEDICARE: DR. HAKAM KHAZRIK 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
1207RX0202XMedical Oncology PhysicianME157856FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154617496
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAKAM KHAZRIK MD
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line : ATTN CREDENTIALING
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8500
Fax Number :
Provider Business Practice Location Address
First Line : 4100 WATERMAN WAY
Second Line :
City : TAVARES
State : FL
Zip : 32778-5270
Country : US
Telephone Number : 352-343-1117
Fax Number : 866-445-2968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2011
Last Update Date : 08/09/2022

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