Provider Demographics
NPI:1497912380
Name:VADAKEKUT, ELSA S (DO)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:S
Last Name:VADAKEKUT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-713-4400
Mailing Address - Fax:405-713-4473
Practice Address - Street 1:3435 NW 56TH ST STE 600
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4442
Practice Address - Country:US
Practice Address - Phone:405-713-4400
Practice Address - Fax:405-713-4473
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4337207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology