Provider Demographics
NPI:1407810989
Name:KHOT, BILQUIS IMTIAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:BILQUIS
Middle Name:IMTIAZ
Last Name:KHOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BILQUIS
Other - Middle Name:IMTIAZ
Other - Last Name:BADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1801 FOREST HILLS BLVD.
Mailing Address - Street 2:STE. 201
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715
Mailing Address - Country:US
Mailing Address - Phone:479-876-6566
Mailing Address - Fax:479-876-2933
Practice Address - Street 1:1801 FOREST HILLS BLVD.
Practice Address - Street 2:STE. 201
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72715
Practice Address - Country:US
Practice Address - Phone:479-876-6566
Practice Address - Fax:479-876-2933
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4714207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine