Healthcare Provider Details

I. General information

NPI: 1346297553
Provider Name (Legal Business Name): MANASH K SARCAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S GARNETT RD SUITE 300
TULSA OK
74146-5229
US

IV. Provider business mailing address

926 DELAWARE ST
SHREVEPORT LA
71106-1504
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-2944
  • Fax: 918-664-2521
Mailing address:
  • Phone: 318-453-7682
  • Fax: 918-664-6120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD017182
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: