Provider Demographics
NPI:1588846521
Name:DUTTA, SAKUNTALA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SAKUNTALA
Middle Name:
Last Name:DUTTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SAKUNTALA
Other - Middle Name:SESHACHALAM
Other - Last Name:DUTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4908 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-1846
Mailing Address - Country:US
Mailing Address - Phone:405-751-6619
Mailing Address - Fax:
Practice Address - Street 1:4908 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-1846
Practice Address - Country:US
Practice Address - Phone:405-751-6619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK129292085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology