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NPI Code Detail

MEDICARE: DR. AHSAN Y KHAN MD

MEDICARE: DR. AHSAN Y 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
12084P0800XPsychiatry Physician2010028278MO
22084P0800XPsychiatry Physician28725OK

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 : 1346245479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AHSAN Y KHAN MD
Provider Business Mailing Address
First Line : PO BOX 12978
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73157-2978
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2617 GENERAL PERSHING BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-6437
Country : US
Telephone Number : 405-858-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/17/2018

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