| Dr Ghazali Ataullah Khan, MD | |
|
301 Grady Road, Etowah, TN 37331-0325 | |
| (423) 263-2444 | |
| (423) 263-1553 |
| Full Name | Dr Ghazali Ataullah Khan |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 41 Years |
| Location | 301 Grady Road, Etowah, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437116720 | NPI | - | NPPES |
| 3086308 | Medicaid | TN | |
| 4031195 | Other | TN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 025977 (Tennessee) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | 025977 (Tennessee) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Total Renal Care, Inc. | Etowah, TN | Dialysis facility |
| Amedisys Home Health Chattanooga | Chattanooga, TN | Home health agency |
| Starr Regional Medical Center Athens | Athens, TN | Hospital |
| Unity Medical Center | Manchester, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Coffee Medical Group Llc | 1850208794 | 15 |
| Summit Medical Group, Pllc | 2860396330 | 516 |
| Entity Name | Coffee Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013969179 PECOS PAC ID: 1850208794 Enrollment ID: O20031118000203 |
| Entity Name | Summit Medical Group, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659090298 PECOS PAC ID: 2860396330 Enrollment ID: O20031125000793 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ghazali Ataullah Khan, MD Po Box 325, Etowah, TN 37331-0325 Ph: (423) 263-2444 | Dr Ghazali Ataullah Khan, MD 301 Grady Road, Etowah, TN 37331-0325 Ph: (423) 263-2444 |
Dr. Russell Brandon Watters Iii, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 301 Grady Rd, Etowah, TN 37331 Phone: 423-263-2444 Fax: 423-263-1553 | |
Dr. Nathan Craig Trentham, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 301 Grady Road, Etowah, TN 37331 Phone: 423-263-2444 Fax: 423-263-1553 | |
Dr. Joel Craig Riley Ii, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 301 Grady Rd, Etowah, TN 37331 Phone: 423-263-2444 Fax: 423-263-1553 | |
Dr. Samuel John Olsen Ii, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 301 Grady Rd, Etowah, TN 37331 Phone: 423-263-2444 Fax: 423-263-1553 |