MEDICARE: IRFAN JAMIL KHAN M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1497286207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRFAN JAMIL KHAN M.D.

Provider Business Mailing Address
First Line	:	8798 DARLENE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-5892
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8500
Country	:	US
Telephone Number	:	913-588-7076
Fax Number	:

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

Provider Enumeration Date	:	03/23/2017
Last Update Date	:	03/23/2017

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