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General NPI Number Information
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NPI Number | 1447796545
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Entity Type | Organization
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Legal Business Name | HARESH K AJMERA MD INC
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 1145 S UTICA AVE SUITE 500
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City | TULSA
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State | OK
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Zip | 74104-4014
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Country | US
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Telephone | 918-744-8115
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Fax | 918-744-8117
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Provider Business Mailing Address
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Address Line | 1145 S UTICA AVE SUITE 500
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City | TULSA
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State | OK
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Zip | 74104-4014
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Country | US
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Telephone | 918-744-8115
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Fax | 918-744-8117
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BHARATI H AJMERA
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Credential |
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Telephone | 918-744-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10644
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License Number State | OK
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