Azhar U Khan MD PC
Organization Active NPI Specialist · Oklahoma City, OK
NPI 1912923178 · NPPES record last updated May 4, 2021
Key facts
- NPI
- 1912923178
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 19711 (OK)
- Legal business name
- AZHAR U KHAN MD PC
- Practice address
- 3366 NW Expressway St Ste 650
Oklahoma City, OK 73112-4490 - Phone
- (405) 947-3347
- Fax
- (405) 947-4232
- NPI assigned
- Jul 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Azhar U Khan, M.D.
- Title
- Owner
- Phone
- (405) 947-3347
Practitioners 1
-
Azhar Ullah Khan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060922000261 | OK | Part B Supplier - Clinic/Group Practice | 1355346404 |
Receives reassigned benefits from 1 practitioner Practice locations: Edmond, OK |
National Provider Directory
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/4e25fccd-d74e-480d-8ad9-77a7a01a54de/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 19711 | OK | Yes |
Addresses
Primary practice location
3366 NW Expressway St Ste 650
Oklahoma City, OK 73112-4490
Mailing address
3366 NW Expressway
Suite 660
Oklahoma City, OK 73112-4462
Phone (405) 947-3345
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100226590B | Medicaid | OK | |
| 290012708 | Other | OK | RAILROAD MEDICARE |
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.