Provider Demographics
NPI:1194922765
Name:KHAN, SOHAIL (MD)
Entity type:Individual
Prefix:DR
First Name:SOHAIL
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 MAGNOLIA WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-9485
Mailing Address - Country:US
Mailing Address - Phone:706-426-7342
Mailing Address - Fax:888-383-7386
Practice Address - Street 1:1701 MAGNOLIA WAY STE 201
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-9485
Practice Address - Country:US
Practice Address - Phone:706-426-7642
Practice Address - Fax:888-383-7386
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA061106207WX0107X
GA02339207W00000X
GA61160207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist