| Dr Ibrahim Ali Khan, MD | |
|
111 W Vernon Ave, Fergus Falls, MN 56537 | |
| (218) 739-2221 | |
| Not Available |
| Full Name | Dr Ibrahim Ali Khan |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 111 W Vernon Ave, Fergus Falls, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326667684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 75036 (Minnesota) | Primary |
| Entity Name | Prairie Ridge Hospital And Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407838329 PECOS PAC ID: 0648222349 Enrollment ID: O20050210000490 |
| Entity Name | Lake Region Healthcare Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093713372 PECOS PAC ID: 3971565334 Enrollment ID: O20060109000246 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ibrahim Ali Khan, MD 712 S Cascade St, Fergus Falls, MN 56537 Ph: (218) 736-8000 | Dr Ibrahim Ali Khan, MD 111 W Vernon Ave, Fergus Falls, MN 56537 Ph: (218) 739-2221 |
Lonnie William Berger, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 712 S Cascade St, Fergus Falls, MN 56537 Phone: 218-736-8000 Fax: 218-739-6718 | |
Daniel L Lembcke, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 712 South Cascade Street, Fergus Falls, MN 56537 Phone: 218-736-8000 Fax: 218-736-8757 | |
Tyler Lacey, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 111 W Vernon Ave, Fergus Falls, MN 56537 Phone: 218-739-2221 | |
Patricia J. Lindholm, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 712 South Cascade Street, Fergus Falls, MN 56537 Phone: 218-736-8000 Fax: 218-739-6742 | |
Michael J Vanvalkenburg, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 712 South Cascade Street, Fergus Falls, MN 56537 Phone: 218-736-8000 Fax: 218-736-8757 | |
Robert A Vennerstrom, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 712 South Cascade Street, Fergus Falls, MN 56537 Phone: 218-736-8000 Fax: 218-739-6742 |