Provider Demographics
NPI:1881678076
Name:AYITEY, ROSEMARY N (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:N
Last Name:AYITEY
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 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-912-3120
Mailing Address - Fax:405-912-3139
Practice Address - Street 1:700 S TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160
Practice Address - Country:US
Practice Address - Phone:405-912-3120
Practice Address - Fax:405-912-3139
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200007760BMedicaid
OK200007760AMedicaid
OK22326OtherMEDICAL LICENSE