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NPI Code Detail

MEDICARE: DR. POORNACHANDRAN MOHANKUMAR M.D.,

MEDICARE: DR. POORNACHANDRAN MOHANKUMAR M.D.,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician45143OK
2208M00000XHospitalist Physician45143OK

General Provider Information

NPI Number : 1538806278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. POORNACHANDRAN MOHANKUMAR M.D.,
Provider Business Mailing Address
First Line : 3001 QUAIL SPRINGS PKWY FL 5
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-2640
Country : US
Telephone Number : 405-945-5215
Fax Number : 405-713-2794
Provider Business Practice Location Address
First Line : 4401 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3413
Country : US
Telephone Number : 405-945-5215
Fax Number : 405-713-2794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2022
Last Update Date : 12/01/2025

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