=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891765079
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARCHANA BARVE MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2006
-----------------------------------------------------
Last Update Date | 09/30/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3613 NW 56TH ST SUITE 140
-----------------------------------------------------
City | OKC
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-949-6481
-----------------------------------------------------
Fax | 405-795-5909
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3613 NW 56TH ST SUITE 140
-----------------------------------------------------
City | OKC
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-949-6481
-----------------------------------------------------
Fax | 405-795-5909
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 06-1731541
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 20734
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2081P0010X
-----------------------------------------------------
Taxonomy Name | Pediatric Rehabilitation Medicine Physician
-----------------------------------------------------
License Number | 20734
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------