Provider Demographics
NPI:1750675971
Name:TITUS, AMANDA (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:TITUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4140 W MEMORIAL RD
Mailing Address - Street 2:SUITE 518
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8366
Mailing Address - Country:US
Mailing Address - Phone:405-752-3720
Mailing Address - Fax:405-752-3721
Practice Address - Street 1:4140 W MEMORIAL RD
Practice Address - Street 2:SUITE 518
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8366
Practice Address - Country:US
Practice Address - Phone:405-752-3720
Practice Address - Fax:405-752-3721
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2016-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK28509207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology