| Dastagir A Khan Md Pa | |
|
800 Prudential Dr Jacksonville FL 32207-8202 | |
| (904) 955-7190 | |
| Not Available |
| Full Name | Dastagir A Khan Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 Prudential Dr, Jacksonville, Florida |
| Authorized Official Name and Position | Dastagir A Khan (OWNER) |
| Authorized Official Contact | 9049557190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dastagir A Khan Md Pa 207 Barony Dr Jacksonville FL 32225-6119 Ph: (904) 955-7190 | Dastagir A Khan Md Pa 800 Prudential Dr Jacksonville FL 32207-8202 Ph: (904) 955-7190 |
| NPI Number | 1790996288 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 06/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790996288 | NPI | - | NPPES |
| 270290800 | Medicaid | FL | |
| 57641 | Other | FL | BCBS OF FLORIDA |
| D06811 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME82073 (Florida) | Primary |
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