Healthcare Provider Details

I. General information

NPI: 1295969889
Provider Name (Legal Business Name): A. AMIL MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 SW 59TH ST
OKLAHOMA CITY OK
73119-7026
US

IV. Provider business mailing address

2225 SW 59TH ST
OKLAHOMA CITY OK
73119-7026
US

V. Phone/Fax

Practice location:
  • Phone: 405-478-5222
  • Fax: 405-478-5223
Mailing address:
  • Phone: 405-478-5222
  • Fax: 405-478-5223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12579
License Number StateOK

VIII. Authorized Official

Name: DR. AZHAR AMIL
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 405-478-5222