Provider Demographics
NPI:1881655660
Name:KHAN, AGHA (MD)
Entity Type:Individual
Prefix:DR
First Name:AGHA
Middle Name:
Last Name:KHAN
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 1:7800 NW 85TH TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3385
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5224 E I 240 SERVICE RD STE 303
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-2607
Practice Address - Country:US
Practice Address - Phone:405-608-3800
Practice Address - Fax:405-628-6271
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204713207RC0000X, 207RI0011X, 207UN0901X
FLME67126207RC0000X, 207RI0011X, 207UN0901X, 207UN0901X
OK24817207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200100160AMedicaid
FL266431300Medicaid
OKP00379499OtherRAILROAD MEDICARE
OKOKA100609Medicare PIN
OK200100160AMedicaid
OK242702201Medicare PIN
FL266431300Medicaid
OKOKA100872Medicare PIN
FLE69697Medicare UPIN