MEDICARE: KHALID L KHAN, M.D., P.C.

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	207W00000X	Ophthalmology Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1881747558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHALID L KHAN, M.D., P.C.

Provider Business Mailing Address
First Line	:	216 BATTLE ST E
Second Line	:	SUITE A
City	:	TALLADEGA
State	:	AL
Zip	:	35160-2420
Country	:	US
Telephone Number	:	256-362-1590
Fax Number	:	256-362-1540

Provider Business Practice Location Address
First Line	:	216 BATTLE ST E
Second Line	:	SUITE A
City	:	TALLADEGA
State	:	AL
Zip	:	35160-2420
Country	:	US
Telephone Number	:	256-362-1590
Fax Number	:	256-362-1540

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KHALID L. KHAN
Credential	:	M.D.
Telephone Number	:	256-362-1590

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	09/27/2013

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