Provider Demographics
NPI:1962455733
Name:TRAN, KHA H (MD)
Entity Type:Individual
Prefix:DR
First Name:KHA
Middle Name:H
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:951 COMMERCE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4040
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-998-4455
Practice Address - Fax:419-998-4586
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35084778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2503311Medicaid
OH000000345653OtherANTHEM
OH735056OtherBUCKEYE
OH04607OtherPARAMOUNT
OHP00295806OtherRAILROAD MEDICARE
OH2503311Medicaid
OHTR4140862Medicare PIN
OH735056OtherBUCKEYE