Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | E4732 | AR |
Y | 207R00000X | Internist | E-4732 | AR |
Y | 111NI0900X | Internist | E-4732 | AR |
NPI | 1023107935 |
---|---|
Provider Name | Dr. Khalid Rayaz |
First Address | Little Rock, AR 72212-4417 |
Second Address | Little Rock, AR 72205-4417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 01/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180380001 | (05) | AR |
5H886G853 | (02) | AR |
5H886GA32 | (02) | AR |
P01120993 | RAILROAD MEDICARE (01) | AR |