Healthcare Provider Details

I. General information

NPI: 1134708589
Provider Name (Legal Business Name): TEJAS SANJAY NANDURKAR MD, MHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104-5018
US

IV. Provider business mailing address

800 ROSE ST
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4426
  • Fax:
Mailing address:
  • Phone: 859-323-6162
  • Fax: 859-257-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1134708589
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number1134708589
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: