Provider Demographics
NPI:1013401462
Name:KHAN, MUHAMMAD IJLAL (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD IJLAL
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE 2ND FLOOR WING C
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-257-8562
Mailing Address - Fax:859-257-7411
Practice Address - Street 1:135 E MAXWELL ST FL 3
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2640
Practice Address - Country:US
Practice Address - Phone:859-218-5350
Practice Address - Fax:859-323-7660
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QS1000X
KY54933207RP1001X, 207RC0200X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty