Provider Demographics
NPI:1952531949
Name:KHATOUN, MAZEN Y (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:MAZEN
Middle Name:Y
Last Name:KHATOUN
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9531 E DANFORTH PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9236
Mailing Address - Country:US
Mailing Address - Phone:520-574-1514
Mailing Address - Fax:520-574-1514
Practice Address - Street 1:2001 E IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-1847
Practice Address - Country:US
Practice Address - Phone:520-297-7165
Practice Address - Fax:520-294-8625
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist