| Khatib Family Practice Plc | |
|
2755 Silver Creek Rd Suite 109 Bullhead City AZ 86442-7904 | |
| (928) 763-9009 | |
| (928) 763-9292 |
| Full Name | Khatib Family Practice Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 2755 Silver Creek Rd, Bullhead City, Arizona |
| Authorized Official Name and Position | Susan Khatib (OFFICE MANAGER) |
| Authorized Official Contact | 9287639009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Khatib Family Practice Plc Po Box 20758 Bullhead City AZ 86439-0758 Ph: (928) 763-9009 | Khatib Family Practice Plc 2755 Silver Creek Rd Suite 109 Bullhead City AZ 86442-7904 Ph: (928) 763-9009 |
| NPI Number | 1528251667 |
|---|---|
| Provider Enumeration Date | 08/22/2007 |
| Last Update Date | 12/18/2007 |
| Medicare PECOS PAC ID | 8325006299 |
|---|---|
| Medicare Enrollment ID | O20041222000760 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528251667 | NPI | - | NPPES |
| 434572001 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 26804 (Arizona) | Primary |
| Provider Name | Nadim B Khatib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578526562 PECOS PAC ID: 1850364787 Enrollment ID: I20040818000309 |
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