=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295473148
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A KUMAR MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2022
-----------------------------------------------------
Last Update Date | 05/20/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5901 W MEMORIAL RD
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73142-2015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-318-9372
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 20782
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73156-0782
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-318-9372
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANJAN KUMAR
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 405-318-9372
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------