Provider Demographics
NPI:1669547048
Name:KHAN, ZUBAIR ASIF (OD)
Entity type:Individual
Prefix:DR
First Name:ZUBAIR
Middle Name:ASIF
Last Name:KHAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9209 NORWICH CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1111
Mailing Address - Country:US
Mailing Address - Phone:260-490-8287
Mailing Address - Fax:
Practice Address - Street 1:515 E COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-1215
Practice Address - Country:US
Practice Address - Phone:260-373-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003265A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist