Khakimov, Djavlon A

Khakimov, Djavlon A is an individual health care provider with primary practice located at 100 Madison Ave , Morristown NJ 07960-6136. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Khakimov, Djavlon A can be contacted via phone (973) 971-5000.

Contact Information

Primary practice address
100 Madison Ave Morristown NJ 07960-6136
Phone: (973) 971-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 25MD00360400 New Jersey
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1285139261
LBN Legal business name Khakimov, Djavlon A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2018
Last updated Sep 28th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285139261 NPPES
New Jersey MEDICAID 00000000000000000000

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