Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 14629R | LA |
NPI | 1033286166 |
---|---|
Provider Name | Abdul Baset Khan |
First Address | Baton Rouge, LA 70809-3726 |
Second Address | Baton Rouge, LA 70809-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 18/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1129950 | (05) | LA |
G92126 | (02) |