Provider Demographics
NPI:1003967977
Name:KHAN, IQBAL AKHTAR YAR (MD)
Entity type:Individual
Prefix:DR
First Name:IQBAL
Middle Name:AKHTAR YAR
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1513 UNION AVE
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-9402
Mailing Address - Country:US
Mailing Address - Phone:660-263-4434
Mailing Address - Fax:660-263-4436
Practice Address - Street 1:1513 UNION AVE
Practice Address - Street 2:SUITE 2800
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-9402
Practice Address - Country:US
Practice Address - Phone:660-263-4434
Practice Address - Fax:660-263-4436
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1136672084N0600X, 2084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209992221Medicaid
G65742Medicare UPIN
001014006Medicare ID - Type Unspecified