Healthcare Provider Details

I. General information

NPI: 1346628856
Provider Name (Legal Business Name): ANKUR RUGHANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 07/28/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 NW 56TH ST STE 500
OKLAHOMA CITY OK
73112-4470
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US

V. Phone/Fax

Practice location:
  • Phone: 405-713-7060
  • Fax: 405-713-7064
Mailing address:
  • Phone: 405-713-7060
  • Fax: 405-713-7064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number31488
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: