Provider Demographics
NPI:1437259660
Name:KHOT, PRAKASH N (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAKASH
Middle Name:N
Last Name:KHOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-0327
Mailing Address - Country:US
Mailing Address - Phone:336-838-9990
Mailing Address - Fax:336-838-9995
Practice Address - Street 1:1216 SCHOOL ST STE D
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2634
Practice Address - Country:US
Practice Address - Phone:336-838-9990
Practice Address - Fax:336-838-9995
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC19016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135JPMedicaid
2163893DMedicare PIN
NCC43514Medicare UPIN