Provider Demographics
NPI:1104379239
Name:KHAN, USMAN AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:USMAN
Middle Name:AHMAD
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 STANTON L YOUNG BLVD
Mailing Address - Street 2:WP2250
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5036
Mailing Address - Country:US
Mailing Address - Phone:405-697-4750
Mailing Address - Fax:405-271-6496
Practice Address - Street 1:920 STANTON L YOUNG BLVD
Practice Address - Street 2:WP2250
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5036
Practice Address - Country:US
Practice Address - Phone:405-697-4750
Practice Address - Fax:405-271-6496
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK32446207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology