Dastagir a Khan MD, PA

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

ARNP9264398 Issued in FL

Legal business name

DASTAGIR A KHAN MD, PA

Practice address

800 Prudential Dr
Jacksonville, FL 32207-8202

Phone

(904) 955-7190

NPI assigned

Dec 2, 2010

Last updated

Dec 2, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dastagir Khan, M.D.NPI 1205818911

Title

Physician

Phone

(904) 955-7190

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dastagir Alam Khan, MD

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1205818911
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1073815676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 BARONY DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256119",
            "telephone_number": "904-955-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-955-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DASTAGIR A KHAN MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "DASTAGIR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "904-955-7190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "ARNP9264398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan M Darragh, PT, DPT, ATC
• Darla Darty
• Karen Dash
• Jayanth Dasika, M.D.
• Dastagir a Khan MD PA
• Jaraad Dattadeen, MD
• Danielle Dattilo, LMHC
• Carrie Daub
• Felicha Daughtry
• Sherry G Daughtry, PHARM.D.

• General Acute Care Hospital in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Acute Care Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.