Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301081855 | MI |
N | 207X00000X | Orthopaedic Surgeon | MD19196 | ME |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 4301081855 | MI |
NPI | 1285842468 |
---|---|
Provider Name | Dr. John I Khoury |
First Address | Holland, MI 49424-2196 |
Second Address | Holland, MI 49424-2196 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2007 |
Last Update Date | 20/02/2017 |