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NPI Code Detail

MEDICARE: PARISSA KESHAVARZIAN FERGUSON PA

MEDICARE: PARISSA KESHAVARZIAN FERGUSON PA
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
1363A00000XPhysician Assistant4405OK

General Provider Information

NPI Number : 1649882556
Entity Type Code : Individual
Provider Name (Legal Business Name) : PARISSA KESHAVARZIAN FERGUSON PA
Provider Business Mailing Address
First Line : 5030 N MAY AVE # 299
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-6010
Country : US
Telephone Number : 405-653-9161
Fax Number : 405-653-9163
Provider Business Practice Location Address
First Line : 3555 NW 58TH ST STE 910-W
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-4707
Country : US
Telephone Number : 405-653-9161
Fax Number : 405-653-9163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2020
Last Update Date : 03/02/2026

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Directions to “ PARISSA KESHAVARZIAN FERGUSON PA” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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