Provider Demographics
NPI:1174485783
Name:KHAN PHYSICIAN SERVICES PLLC
Entity type:Organization
Organization Name:KHAN PHYSICIAN SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AWAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-918-6024
Mailing Address - Street 1:14812 LOST FALLS WAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-8505
Mailing Address - Country:US
Mailing Address - Phone:860-918-6024
Mailing Address - Fax:305-845-7394
Practice Address - Street 1:14812 LOST FALLS WAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-8505
Practice Address - Country:US
Practice Address - Phone:860-918-6024
Practice Address - Fax:305-845-7394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty