Provider Demographics
NPI:1033607684
Name:KHAN, SARAH SOHAIL
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SOHAIL
Last Name:KHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-8983
Mailing Address - Country:US
Mailing Address - Phone:918-859-8064
Mailing Address - Fax:
Practice Address - Street 1:1373 E BOONE ST STE 2300
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3365
Practice Address - Country:US
Practice Address - Phone:918-207-0025
Practice Address - Fax:918-207-0226
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT3803207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program