Provider Demographics
NPI:1649587635
Name:JALIL, BASMAH ATHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BASMAH
Middle Name:ATHAR
Last Name:JALIL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:916 DELAWARE AVE APT 1O
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1852
Mailing Address - Country:US
Mailing Address - Phone:505-554-8398
Mailing Address - Fax:
Practice Address - Street 1:6160 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1930
Practice Address - Country:US
Practice Address - Phone:918-495-2685
Practice Address - Fax:918-495-2660
Is Sole Proprietor?:No
Enumeration Date:2010-09-12
Last Update Date:2019-07-02
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Provider Licenses
StateLicense IDTaxonomies
OK34695207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology