Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 113667 | MO |
N | 2084N0600X | Clinical Neurophysiologist | 113667 | MO |
N | 2084V0102X | Vascular Neurology | 113667 | MO |
NPI | 1003967977 |
---|---|
Provider Name | Dr. Iqbal Akhtar Yar Khan |
First Address | Moberly, MO 65270-9402 |
Second Address | Moberly, MO 65270-9402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 27/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
209992221 | (05) | MO |
G65742 | (02) |