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General NPI Number Information
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NPI Number | 1366490252
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Entity Type | Individual
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Provider Name | RAJKUMAR P REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 900 N PORTER AVE
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City | NORMAN
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State | OK
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Zip | 73071-6485
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Country | US
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Telephone | 405-579-1444
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Fax | 405-579-1448
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Provider Business Mailing Address
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Address Line | 1709 RUIDOSA DR
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City | EDMOND
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State | OK
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Zip | 73034-6848
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Country | US
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Telephone | 405-359-6353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 17957
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License Number State | OK
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