Provider Demographics
NPI:1548642473
Name:KHANNA, RAHUL (MD)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:KHANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 S GEAR AVE STE 153
Mailing Address - Street 2:
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1686
Mailing Address - Country:US
Mailing Address - Phone:319-754-4400
Mailing Address - Fax:319-754-4412
Practice Address - Street 1:1225 S GEAR AVE STE 153
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1686
Practice Address - Country:US
Practice Address - Phone:319-754-4400
Practice Address - Fax:319-754-4412
Is Sole Proprietor?:No
Enumeration Date:2015-06-27
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-460662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology