Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 006628 | GA |
N | 111NI0900X | Internist | 006628 | GA |
Y | 207RI0011X | Interventional Cardiology | 53688 | KY |
NPI | 1063844959 |
---|---|
Provider Name | Dr. Mohammed Hasan Khan |
First Address | Ashland, KY 41105-2379 |
Second Address | Ashland, KY 41101-2868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2013 |
Last Update Date | 08/10/2020 |