Healthcare Provider Details

I. General information

NPI: 1417034166
Provider Name (Legal Business Name): I AHMAD AND S AHMAD MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NW 9TH SUITE 4000
OKLAHOMA CITY OK
73102-1058
US

IV. Provider business mailing address

608 NW 9TH SUITE 4000
OKLAHOMA CITY OK
73102-1058
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-8383
  • Fax: 405-231-8745
Mailing address:
  • Phone: 405-272-8383
  • Fax: 405-231-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12063
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number14498
License Number StateOK

VIII. Authorized Official

Name: DR. IFTIKHAR AHMAD
Title or Position: OWNER
Credential: MD
Phone: 405-272-8383