Healthcare Provider Details

I. General information

NPI: 1154434405
Provider Name (Legal Business Name): ADAM ASCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 NE 13TH ST ORI 274
OKLAHOMA CITY OK
73117-1039
US

IV. Provider business mailing address

800 NE 10TH ST
OKLAHOMA CITY OK
73104-5418
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8299
  • Fax: 405-271-9180
Mailing address:
  • Phone: 405-271-8299
  • Fax: 405-271-9180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number200601074
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number30572
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: