Basic Information
| Provider Information | |||||||||
| NPI: | 1003042029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | AFRASYAB | ||||||||
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| Mailing Information | |||||||||
| Address1: | AFRASYAB KHAN, HOUSE 97, STREET 2, K3, | ||||||||
| Address2: | PHASE 3, HAYATABAD. | ||||||||
| City: | PESHAWAR | ||||||||
| State: | NWFP | ||||||||
| PostalCode: | 25000 | ||||||||
| CountryCode: | PK | ||||||||
| TelephoneNumber: | 0092915826827 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 SW ARCHER RD | ||||||||
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| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326103003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522650680 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2009 | ||||||||
| LastUpdateDate: | 06/04/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | TRN13667 | FL | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | TRN13667 | 01 | FL | TRN NUMBER | OTHER |