Provider Demographics
NPI:1932360682
Name:KHAKHARIA, SAURABH (MD)
Entity Type:Individual
Prefix:
First Name:SAURABH
Middle Name:
Last Name:KHAKHARIA
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:PO BOX 2169
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31776-2169
Mailing Address - Country:US
Mailing Address - Phone:229-891-9028
Mailing Address - Fax:229-891-9033
Practice Address - Street 1:3 MAGNOLIA CT
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-6764
Practice Address - Country:US
Practice Address - Phone:229-891-9028
Practice Address - Fax:229-891-9033
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA064121207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery