Most Relevant Information
Provider Data
| NPI Number: | 1003820291 |
| Provider Name: | FAZAL M KHAN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2083A0300X |
| Specialty: | Preventive Medicine |
| License Number: | 76623 |
Most Important Dates
| Enumeration Date: | 07/27/2006 |
| Last Updated: | 11/08/2021 |
Provider Practice Location
200 WISTERIA DR
GAINESVILLE
GA
305013827
Practice Location Phone/Fax
| Phone: | 7702195407 |
| Fax: |
Provider Mailing Location
PO BOX 742616
ATLANTA
GA
303742616
Provider Mailing Phone/Fax
| Phone: | 7702198420 |
| Fax: |