1780979963 NPI number — DR. MUHAMMAD OMER KHOKHAR M.D.

Table of content: DR. MUHAMMAD OMER KHOKHAR M.D. (NPI 1780979963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780979963 NPI number — DR. MUHAMMAD OMER KHOKHAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHOKHAR
Provider First Name:
MUHAMMAD
Provider Middle Name:
OMER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780979963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 CONTINENTAL DRIVE, SUITE 406
Provider Second Line Business Mailing Address:
IPC-THE HOSPITALIST COMPANY.
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-8112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-984-2577
Provider Business Mailing Address Fax Number:
302-368-1271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
608 N ACADIA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THIBODAUX
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70301-4847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-493-4346
Provider Business Practice Location Address Fax Number:
985-449-2560
Provider Enumeration Date:
06/15/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X , with the licence number:  312574 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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