Provider Demographics
NPI:1578744348
Name:SATWANT TANDON MD PC
Entity Type:Organization
Organization Name:SATWANT TANDON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-451-6652
Mailing Address - Street 1:4246 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8129
Mailing Address - Country:US
Mailing Address - Phone:918-451-6652
Mailing Address - Fax:918-451-7261
Practice Address - Street 1:DEWEY BARTLETT AND MAIN
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437-8129
Practice Address - Country:US
Practice Address - Phone:918-451-6652
Practice Address - Fax:918-451-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19207174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty