Provider Demographics
NPI:1437296001
Name:SURJA, ANTON A (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:A
Last Name:SURJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:226 SE DEBELL
Mailing Address - Street 2:BLDG A
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006
Mailing Address - Country:US
Mailing Address - Phone:918-331-1020
Mailing Address - Fax:918-331-1021
Practice Address - Street 1:226 SE DEBELL
Practice Address - Street 2:BLDG A
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006
Practice Address - Country:US
Practice Address - Phone:918-331-1020
Practice Address - Fax:918-331-1021
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK253712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry