Provider Demographics
NPI:1134328487
Name:KHATRI, JYOTI (MBBS)
Entity Type:Individual
Prefix:DR
First Name:JYOTI
Middle Name:
Last Name:KHATRI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CREIGHTON FAMILY MEDICINE
Mailing Address - Street 2:601 N 30TH STREET, SUITE 6702
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2137
Mailing Address - Country:US
Mailing Address - Phone:402-280-4318
Mailing Address - Fax:402-280-5165
Practice Address - Street 1:CREIGHTON FAMILY MEDICINE
Practice Address - Street 2:601 N 30TH STREET, SUITE 6702
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2137
Practice Address - Country:US
Practice Address - Phone:402-280-4318
Practice Address - Fax:402-280-5165
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine