Provider Demographics
NPI:1164759791
Name:MUDASSIR, ASMA (MD)
Entity Type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:MUDASSIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASMA
Other - Middle Name:
Other - Last Name:JAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 FOXBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4479
Mailing Address - Country:US
Mailing Address - Phone:405-321-6499
Mailing Address - Fax:
Practice Address - Street 1:900 E. MAIN ST
Practice Address - Street 2:GRIFFIN MEMORIAL HOSPITAL
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4479
Practice Address - Country:US
Practice Address - Phone:405-321-4880
Practice Address - Fax:405-573-6684
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK269882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry