Abdurrahman Khattab

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

NPI 1710604145 · NPPES record last updated Oct 26, 2022

Key facts

NPI
1710604145
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
5020 S 72ND East Ave
Tulsa, OK 74145-6805
Phone
(918) 688-1045
NPI assigned
Oct 26, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

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

Addresses

Primary practice location

5020 S 72ND East Ave
Tulsa, OK 74145-6805

Mailing address

5020 S 72ND East Ave
Tulsa, OK 74145-6805

Other providers in Tulsa, OK

All providers in Tulsa, OK · Student in an Organized Health Care Education/Training Program in Oklahoma

Sources for this page

Verify at the official NPI Registry.