IndividualActive
Jacob Khoussine, MD, PHD
NPI 1063354280 · Ophthalmology Physician · Portland, ME
Provider details
- NPI number
- 1063354280
- Entity type
- Individual
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD, PHD
- Sex
- Male
- Sole proprietor
- No
- License
- EC261086 (ME)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
22 Bramhall St
Portland, ME 04102-3175
Phone: (207) 662-7068
Approximate (ZIP-level) locationGet directions
Mailing address
4620 Frey St Apt 115
Madison, WI 53705-2903
Registry dates
- Enumerated
- 2026-04-07
- Last updated
- 2026-04-07
- Certified
- 2026-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.