Provider Demographics
NPI:1871563445
Name:KHOURY, JOSEPH GEORGE (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:GEORGE
Last Name:KHOURY
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 1:6535 NEMOURS PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7884
Mailing Address - Country:US
Mailing Address - Phone:407-650-7715
Mailing Address - Fax:407-650-7265
Practice Address - Street 1:6535 NEMOURS PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7884
Practice Address - Country:US
Practice Address - Phone:407-650-7715
Practice Address - Fax:407-650-7265
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1301242086S0120X, 207XP3100X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102775OtherBLUE CROSS
AL100915Medicaid
AL121707Medicaid
AL51598791OtherBLUE CROSS
AL009942849Medicaid
AL009942850Medicaid
AL051541030OtherBLUE CROSS
MS04500046Medicaid
AL051541032OtherBLUE CROSS
AL051541034OtherBLUE CROSS
AL009942847Medicaid
AL051591742OtherBLUE CROSS
AL009942846Medicaid
AL051541027OtherBLUE CROSS
AL051542848Medicaid
AL051547826OtherBLUE CROSS
AL051109076OtherBLUE CROSS
AL051541033OtherBLUE CROSS
AL051541033OtherBLUE CROSS
AL051541032OtherBLUE CROSS
AL051542848Medicaid