Provider Demographics
NPI:1003894569
Name:VIJ, VIKAS (MD)
Entity Type:Individual
Prefix:
First Name:VIKAS
Middle Name:
Last Name:VIJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 NW 56TH ST, SUITE C-40
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4455
Mailing Address - Country:US
Mailing Address - Phone:405-945-4741
Mailing Address - Fax:888-972-5320
Practice Address - Street 1:3433 NW 56TH ST, SUITE C-40
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4455
Practice Address - Country:US
Practice Address - Phone:405-945-4741
Practice Address - Fax:888-972-5320
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA852432085N0700X
OK252982085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200110210AMedicaid
OKI32804Medicare UPIN
OK200110210AMedicaid
OK246716203Medicare PIN
OK246716201Medicare PIN
OKP00468612Medicare PIN
OKP00415258Medicare PIN
OK246716202Medicare PIN
OK248723019Medicare PIN