Healthcare Provider Details

I. General information

NPI: 1053874966
Provider Name (Legal Business Name): NAVEED QAZI FARRUKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NE 13TH ST
OKLAHOMA CITY OK
73104-5004
US

IV. Provider business mailing address

3125 WINDY HILL LN
EDMOND OK
73034-6191
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6651
  • Fax: 405-271-1476
Mailing address:
  • Phone: 205-447-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD94586
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number45831
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.148506
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD94586
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.148506
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: