Provider Demographics
NPI:1528037165
Name:KHATRI, JAIKIRSHAN J (MD)
Entity Type:Individual
Prefix:
First Name:JAIKIRSHAN
Middle Name:J
Last Name:KHATRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # J3-5
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-973-6281
Mailing Address - Fax:216-636-9981
Practice Address - Street 1:7255 OLD OAK BLVD C208
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HTS
Practice Address - State:OH
Practice Address - Zip Code:44130
Practice Address - Country:US
Practice Address - Phone:440-816-2708
Practice Address - Fax:440-243-8480
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048906207RC0000X
OH35087431207RC0000X
OH35.087431207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease