Provider Demographics
NPI:1790702389
Name:ARANAYDO, LINDA SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUSAN
Last Name:ARANAYDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1312
Mailing Address - Street 2:FNB DEPT 001
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6303
Mailing Address - Country:US
Mailing Address - Phone:918-756-4300
Mailing Address - Fax:918-759-2081
Practice Address - Street 1:1313 E 20TH ST
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6303
Practice Address - Country:US
Practice Address - Phone:918-758-2717
Practice Address - Fax:918-756-4490
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77816207Q00000X
OK26656207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G778160Medicaid
G73760Medicare UPIN
CA00G778160Medicaid