| Khoukaz Internal Medicine, Llc | |
|
3915 Watson Rd Suite 100 Saint Louis MO 63109-1251 | |
| (314) 646-0478 | |
| (314) 646-0698 |
| Full Name | Khoukaz Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3915 Watson Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Ghassan Khoukaz (OWNER OF PRACTICE) |
| Authorized Official Contact | 3145775778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Khoukaz Internal Medicine, Llc 1836 Lackland Hill Pkwy Saint Louis MO 63146-3572 Ph: (314) 989-0300 | Khoukaz Internal Medicine, Llc 3915 Watson Rd Suite 100 Saint Louis MO 63109-1251 Ph: (314) 646-0478 |
| NPI Number | 1871565804 |
|---|---|
| Provider Enumeration Date | 02/03/2006 |
| Last Update Date | 10/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871565804 | NPI | - | NPPES |
| DF6432 | Other | MO | RR MEDICARE GROUP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2005005178 (Missouri) | Primary |
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