Momin Rahim Khan, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Batesville, AR

NPI 1245080811 · NPPES record last updated Mar 25, 2024

Key facts

NPI
1245080811
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1710 Harrison St
Batesville, AR 72501-7303
Phone
(870) 622-1200
NPI assigned
Mar 25, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240610001311 AR Order and Referring Only - Other (Non-Physician) 9032651799

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: momin.khan.1@13831.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AR Yes

Addresses

Primary practice location

1710 Harrison St
Batesville, AR 72501-7303

Mailing address

5713 Binbranch LN
McKinney, TX 75071-8476
Phone (469) 891-7367

Other providers in Batesville, AR

All providers in Batesville, AR · Student in an Organized Health Care Education/Training Program in Arkansas

Sources for this page

Verify at the official NPI Registry.