Provider Demographics
NPI:1982872875
Name:EUSEBIO C KHO MD PC
Entity Type:Organization
Organization Name:EUSEBIO C KHO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUSEBIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:KHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-752-3043
Mailing Address - Street 1:137 EAST MCCLAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-1846
Mailing Address - Country:US
Mailing Address - Phone:812-752-5659
Mailing Address - Fax:812-752-2927
Practice Address - Street 1:137 EAST MCCLAIN AVENUE
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-1846
Practice Address - Country:US
Practice Address - Phone:812-752-5659
Practice Address - Fax:812-752-2927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50000753A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E13652Medicare UPIN
IN730370Medicare PIN