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General NPI Number Information
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NPI Number | 1396783056
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Entity Type | Individual
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Provider Name | KUMAR B ENNAMURI MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1125 N PORTER AVE STE 300
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City | NORMAN
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State | OK
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Zip | 73071-6443
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Country | US
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Telephone | 405-364-0630
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Fax | 405-506-3046
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Provider Business Mailing Address
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Address Line | 1125 N PORTER AVE STE 300
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City | NORMAN
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State | OK
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Zip | 73071-6443
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Country | US
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Telephone | 405-364-0630
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20474
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License Number State | OK
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