Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 34.007977 | OH |
NPI | 1467403485 |
---|---|
Provider Name | Phillip L Khalil |
First Address | Stow, OH 44224-6841 |
Second Address | Stow, OH 44224-6841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 16/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2666146 | (05) | OH |
H99347 | (02) |