Provider Demographics
NPI:1235470329
Name:FARRUKH SHOHAB KHAN, MD
Entity Type:Organization
Organization Name:FARRUKH SHOHAB KHAN, MD
Other - Org Name:COLUMBUS NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARRUKH
Authorized Official - Middle Name:SHOHAB
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-221-8799
Mailing Address - Street 1:1800 WARM SPRINGS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8059
Mailing Address - Country:US
Mailing Address - Phone:706-221-8799
Mailing Address - Fax:706-221-8979
Practice Address - Street 1:1800 WARM SPRINGS RD
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8059
Practice Address - Country:US
Practice Address - Phone:706-221-8799
Practice Address - Fax:706-221-8979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA690172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE8165Medicare UPIN