Healthcare Provider Details

I. General information

NPI: 1437189198
Provider Name (Legal Business Name): AKSHEY BHANOT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4418
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE. 280
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-3011
  • Fax:
Mailing address:
  • Phone: 405-949-3011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01065802A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28257
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2005019442
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: