MEDICARE: GURPREET KHAKH

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
1	282N00000X	General Acute Care Hospital
2	2084N0400X	Neurology Physician	2014019451	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2014019451	OTHER	MO	MISSOURI TEMPORARY LICENSE NUMBER

General Provider Information

NPI Number	:	1265847883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GURPREET KHAKH

Provider Business Mailing Address
First Line	:	1 HOSPITAL DRIVE
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202
Country	:	US
Telephone Number	:	573-882-1515
Fax Number	:	573-884-0070

Provider Business Practice Location Address
First Line	:	1 HOSPITAL DRIVE
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202
Country	:	US
Telephone Number	:	573-882-1515
Fax Number	:	573-884-0070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	05/11/2026

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Directions to “ GURPREET KHAKH ” Practice Location

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