Provider Demographics
NPI:1932210762
Name:EL-KHATIB, HUSSEIN E (MD)
Entity type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:E
Last Name:EL-KHATIB
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 1:100 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:855-446-5937
Mailing Address - Fax:740-446-5317
Practice Address - Street 1:401 DIVISION ST STE 20425387
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1455
Practice Address - Country:US
Practice Address - Phone:304-767-7850
Practice Address - Fax:304-767-7855
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV177712084P0800X
OH35.1322542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3020779Medicaid
WV0116193000Medicaid
WVEL0824672Medicare ID - Type Unspecified
WV0116193000Medicaid