Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | RR7990 | IA |
N | 208200000X | Surgeon | 40787 | IA |
N | 208600000X | Surgeon | 40787 | IA |
Y | 2086S0102X | Surgical Critical Care | 55958 | KY |
N | 2086S0102X | Surgical Critical Care | TP202 | KY |
NPI | 1407030950 |
---|---|
Provider Name | Dr. Prashant Khullar |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Edgewood, KY 41017-3403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2007 |
Last Update Date | 17/09/2021 |