Provider Demographics
NPI:1306866827
Name:NEMRI, KAMIL S (MD)
Entity Type:Individual
Prefix:
First Name:KAMIL
Middle Name:S
Last Name:NEMRI
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:PO BOX 888
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:OK
Mailing Address - Zip Code:73052-0888
Mailing Address - Country:US
Mailing Address - Phone:405-756-1404
Mailing Address - Fax:405-756-1476
Practice Address - Street 1:1305 W. CHEROKEE
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:OK
Practice Address - Zip Code:73052
Practice Address - Country:US
Practice Address - Phone:405-756-1404
Practice Address - Fax:405-756-1476
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23221207Q00000X
TXM0509207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H97418Medicare UPIN