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General NPI Number Information
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NPI Number | 1932328473
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Entity Type | Individual
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Provider Name | CLAUDIA L. ROSSAVIK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8009 LAKEHURST DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-4325
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Country | US
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Telephone | 405-842-2941
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Fax | 405-842-7920
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Provider Business Mailing Address
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Address Line | 8009 LAKEHURST DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-4325
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Country | US
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Telephone | 405-842-2941
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Fax | 405-842-7920
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 17170
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License Number State | OK
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