Provider Demographics
NPI:1376570812
Name:HANDIE, ANDRONICA S (DPM)
Entity Type:Individual
Prefix:
First Name:ANDRONICA
Middle Name:S
Last Name:HANDIE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9709 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4566
Mailing Address - Country:US
Mailing Address - Phone:918-994-4000
Mailing Address - Fax:918-994-4090
Practice Address - Street 1:9709 EAST 79TH STREET
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4566
Practice Address - Country:US
Practice Address - Phone:918-994-4000
Practice Address - Fax:918-294-6939
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR231213E00000X
OK252213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist