Provider Demographics
NPI:1265634562
Name:POKALA, HANUMANTHA RAO (MD)
Entity Type:Individual
Prefix:DR
First Name:HANUMANTHA
Middle Name:RAO
Last Name:POKALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 N WALKER AVE
Mailing Address - Street 2:APT 11306
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1816
Mailing Address - Country:US
Mailing Address - Phone:405-306-9509
Mailing Address - Fax:
Practice Address - Street 1:1200 N PHILLIPS AVE
Practice Address - Street 2:SUITE 14500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4600
Practice Address - Country:US
Practice Address - Phone:405-271-5311
Practice Address - Fax:405-271-3767
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK276822080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology