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General NPI Number Information
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NPI Number | 1730515362
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Entity Type | Organization
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Legal Business Name | FAZAL AKBAR ALI MD PC
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Dates
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Enumeration Date | 09/14/2013
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 4221 S WESTERN AVE STE 5020
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3445
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Country | US
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Telephone | 405-563-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 4221 S WESTERN AVE STE 5020
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3445
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Country | US
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Telephone | 405-563-3998
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | FAZAL AKBAR ALI
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Credential | M.D.
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Telephone | 405-563-3998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 24129
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License Number State | OK
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