DR. KHALID JALIL MANZAR (NPI# 1962469452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962469452 |
| Entity Type | Individual |
| Full Name | DR. KHALID JALIL MANZAR |
| Credential | M.D. |
| Practice Address |
1210 W 5th St Ste 100 London KY 40741-2112 |
| Mailing Address |
Po Box 73652 Cleveland OH 44193-0002 |
| Practice Telephone | 6068644040 |
| Practice Fax Number | 6068643500 |
| Mailing Telephone | 8593132758 |
| Mailing Fax Number | 8592765939 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2016-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
34308 | IA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD457745 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0247221 | 05 | |
| RAILROAD MEDICARE | 060067839 | 01 | |
| MIDLANDS CHOICE | 235475 | 01 | |
| HEALTH ALLIANCE | 071725 | 01 | |
| WELLMARK BC/BS | 43330 | 01 | |
| IOWA HEALTH SOLUTIONS | 67134 | 01 | |
| JOHN DEERE HEALTH | IA0193 | 01 |
| Street Address |
1210 W 5TH ST STE 100 |
| City | LONDON |
| State | KY |
| Zip Code | 40741-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487648200 | The Medical Specialists of Ky, Psc | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2005-09-08 |
| 1164973798 | Randall Mills | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2016-10-19 |
| 1750749065 | Sabrina Lambert | Nurse Practitioner | 1210 W 5th St, London, KY 40741-2112 | 2016-02-01 |
| 1508157223 | Saint Joseph Medical Foundation, Inc | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2011-04-28 |
| 1235429788 | Saint Joseph Medical Foundation, Inc | Nurse Practitioner | 1210 W 5th St, London, KY 40741-2112 | 2011-04-18 |
| 1750698866 | Dana E Campbell | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2010-09-10 |
| 1619200151 | Marymount Medical Center Physician Services | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2009-09-16 |
| 1790916468 | Cristina Cabral Pauig | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2009-07-29 |
| 1174751259 | Sjl Physician Management Services, Inc. | Physician Assistant | 1210 W 5th St, London, KY 40741-2112 | 2009-06-26 |
| 1710115175 | Sjl Physician Management Services Inc. | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2009-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841244 | Emily Anne Simmons | Pharmacist | 1851 West Hwy 192, London, KY 40741 | 2020-11-06 |
| 1871104364 | Jarrod Lee Napier | Optometrist | 103 Chera Lyn Ln, London, KY 40741 | 2020-08-10 |
| 1295378792 | Rebekah Virginia Elaine Cloud | Nurse Practitioner | 1649 Ky- 192 W, London, KY 40741 | 2019-10-28 |
| 1215416581 | Mary Jean Nolan | Nurse Practitioner | 1649 W. Hwy 192, London, KY 40741 | 2018-08-08 |
| 1558849620 | Pinnacle Treatment Centers Ky-1, LLC | Substance Abuse Rehabilitation Facility | 312 Carrera Drive, London, KY 40741 | 2018-08-01 |
| 1710463435 | Pinnacle Treatment Centers Ky-i, LLC | Substance Abuse Rehabilitation Facility | 300 Carrera Drive, London, KY 40741 | 2018-07-16 |
| 1720591076 | Hillary Clark | Nurse Practitioner | 192 London Shopping Ctr Ste 2, London, KY 40741 | 2017-11-08 |
| 1760901979 | Ariel Siler | Counselor | 454 N. Mcwhorter St., Suite 1, London, KY 40741 | 2017-09-19 |
| 1598287161 | Young Smiles,llc | Clinic/Center | 324 Holly Lane, London, KY 40741 | 2017-07-14 |
| 1952727505 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 2645 N Laurel Rd Ste B, London, KY 40741 | 2014-03-06 |
| Find all providers in zip 40741 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093250615 | Advanced Vascular Institute | Internal Medicine | 1374 Highway 192 E, London, KY 40741-3123 | 2017-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659770733 | Scott C Harris Do Pllc | Internal Medicine | 112 Windmere Dr, Bowling Green, KY 42103-8720 | 2014-08-14 |
| 1457554750 | Tullio Emanuele Md, Psc | Internal Medicine | 720 Second Street, Suite 204, Bowling Green, KY 42101-5852 | 2007-06-06 |
| 1083823421 | Our Lady of Bellefonte Hospital | Internal Medicine | 1180 Saint Christopher Dr, Ste. 2, Ashland, KY 41101-7055 | 2007-05-22 |
| 1750359857 | Michele A Friday | Internal Medicine | 1180 Saint Christopher Dr Ste 2, Ashland, KY 41101-7055 | 2006-03-14 |
| 1740255314 | Avichai Eres | Internal Medicine | 161 N Eagle Creek Dr, Suite 400, Lexington, KY 40509-9038 | 2006-02-17 |
| 1053310409 | Mohammed Kazimuddin | Internal Medicine | 825 Second Ave, Ste B1, Bowling Green, KY 42101 | 2005-07-19 |
| 1235645607 | Appalachian Vascular Institute, Pllc | Internal Medicine | 243 Roy Campbell Dr Ste B, Hazard, KY 41701-9485 | 2017-12-21 |
| 1770001877 | Owensboro Health Medical Group, Inc. | Internal Medicine | 2025 W Everly Brothers Blvd, Powderly, KY 42367-5401 | 2017-09-08 |
| 1346788023 | Julie Reinstatler | Internal Medicine | 800 Rose St, Lexington, KY 40536-7001 | 2017-02-02 |
| 1063966778 | Roshan K Mathew, Md. P.s.c. | Internal Medicine | 3110 Fairview Dr, Owensboro, KY 42303-2175 | 2016-08-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. KHALID JALIL MANZAR.
| 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.