Provider Demographics
NPI:1588414601
Name:KHATRI, ABDUL HASEEB (MD)
Entity type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:HASEEB
Last Name:KHATRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ABDUL
Other - Middle Name:HASEEB
Other - Last Name:KHATRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1108 ROSS CLARK CIR STE 210
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3022
Mailing Address - Country:US
Mailing Address - Phone:334-712-3329
Mailing Address - Fax:
Practice Address - Street 1:1108 ROSS CLARK CIR STE 210
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3022
Practice Address - Country:US
Practice Address - Phone:334-712-3329
Practice Address - Fax:334-305-0219
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program