Healthcare Provider Details

I. General information

NPI: 1699768374
Provider Name (Legal Business Name): NASSER JANBAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 S WESTERN AVE
OKLAHOMA CITY OK
73109-3411
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 405-631-0919
  • Fax: 405-636-0518
Mailing address:
  • Phone: 405-631-0919
  • Fax: 405-636-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number48471
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25205
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: