Provider Demographics
NPI:1487706180
Name:KHANI, RAAFAT (DO)
Entity type:Individual
Prefix:
First Name:RAAFAT
Middle Name:
Last Name:KHANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RAAFAT
Other - Middle Name:
Other - Last Name:MOHAMMADKHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4900 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2737
Practice Address - Country:US
Practice Address - Phone:725-269-3368
Practice Address - Fax:725-293-5350
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1487706180Medicaid
NV1487706180Medicaid