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NPI Code Detail

MEDICARE: DR. MAHMOOD A KHAN MD

MEDICARE: DR. MAHMOOD A 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
1207L00000XAnesthesiology PhysicianR2449AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
152803OTHERARAR BCBS

General Provider Information

NPI Number : 1417943671
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAHMOOD A KHAN MD
Provider Business Mailing Address
First Line : PO BOX 22390
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71903-2390
Country : US
Telephone Number : 800-235-1415
Fax Number : 913-234-1108
Provider Business Practice Location Address
First Line : 11401 INTERSTATE 30
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-7042
Country : US
Telephone Number : 501-455-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 03/27/2008

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