Provider Demographics
NPI:1629160684
Name:ANESTHESIOLOGY
Entity Type:Organization
Organization Name:ANESTHESIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF ANESTHESIOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:RAGHUVENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GANTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-270-0501
Mailing Address - Street 1:921, 13 TH STREET
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:OKLAHOMA
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5007
Mailing Address - Country:US
Mailing Address - Phone:405-270-0501
Mailing Address - Fax:405-270-1546
Practice Address - Street 1:921, NE 13 TH STREET
Practice Address - Street 2:7 TH FLOOR
Practice Address - City:OKLAHOMA
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-270-0501
Practice Address - Fax:405-270-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17965281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital