IMTIAZ R KHAN (NPI# 1306137666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306137666 |
| Entity Type | Individual |
| Full Name | IMTIAZ R KHAN |
| Practice Address |
5000 Ambassador Caffery Pkwy Ste A Lafayette LA 70508-6984 |
| Mailing Address |
5959 S Sherwood Forest Blvd Baton Rouge LA 70816-6038 |
| Practice Telephone | 3374703580 |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2019-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 313117 | LA | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 313117 | LA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 56868 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 820 Sherwood Forest Blvd, Baton Rouge, LA 708155262 | 2258021521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356481261 | Imtiaz Ahmad Khan | Emergency Medicine | 1000 Medical Center Blvd, Lawrenceville, GA 30045-7694 | 2007-02-08 |
| 1467481085 | Imtiaz A Khan | Family Medicine | 4200 E North St, Suite 5, Greenville, SC 29615-2437 | 2006-07-03 |
| Street Address |
5000 AMBASSADOR CAFFERY PKWY STE A |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-6984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326694076 | Nathan J Ambrose | Physician Assistant | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2019-08-16 |
| 1720536618 | Richard Davis | Physician Assistant | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2016-09-20 |
| 1063865038 | Vinay Kumar Juneja | Emergency Medicine | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2016-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174732846 | Mohamad Allam | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 155 Hospital Dr #301, Lafayette, LA 70503-2846 | 2007-05-21 |
| 1942220280 | Richard M Dearman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5000 Ambassador Caffery, Province Bldg. 14-a, Lafayette, LA 70508 | 2006-07-20 |
| 1477534402 | Thomas X Aufiero | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1176 N. 16th Street, Lafayette, IN 47904 | 2005-11-08 |
| 1174519466 | Michael Jay Scott Sheridan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1116 N 16th St Ste A, Lafayette, IN 47904 | 2005-09-22 |
| 1922005768 | Mitchell David Lirtzman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2730 Ambassador Caffery Pkwy, Lafayette, LA 70506-5904 | 2005-07-07 |
| 1689825499 | Louisiana Cardiovascular and Limb Salvage Center, Apmc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4811 Ambassador Caffery Parkway, Suite 401a, Lafayette, LA 70508 | 2008-10-10 |
| 1851470033 | Douglas Charles Wallace | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3900 St Francis Way, Ste 201, Lafayette, IN 47905-4923 | 2006-11-06 |
| 1184643512 | John J Schier | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3900 St Francis Way Ste 200, Lafayette, IN 47905-4940 | 2006-07-18 |
| 1770542441 | Kenneth Samuel Stone | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1116 N 16th St, Suite A, Lafayette, IN 47904-2119 | 2006-03-21 |
| 1760489728 | David E Allie | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4811 Ambassador Caffery Parkway, Suite 401a, Lafayette, LA 70508 | 2005-07-06 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.