MEDICARE: DR. MANJU KAUL PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	857	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	680013158	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205821022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANJU KAUL PHD

Provider Business Mailing Address
First Line	:	3015 E SKELLY DR
Second Line	:	SUITE 135
City	:	TULSA
State	:	OK
Zip	:	74105-6317
Country	:	US
Telephone Number	:	918-712-2885
Fax Number	:	918-712-9019

Provider Business Practice Location Address
First Line	:	3015 E SKELLY DR
Second Line	:	SUITE 135
City	:	TULSA
State	:	OK
Zip	:	74105-6317
Country	:	US
Telephone Number	:	918-712-2885
Fax Number	:	918-712-9019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. MANJU KAUL PHD” Practice Location

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