Provider Demographics
NPI:1982838397
Name:TANDON, ANIKA K (MD)
Entity Type:Individual
Prefix:MS
First Name:ANIKA
Middle Name:K
Last Name:TANDON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4606 E. 67TH ST.
Mailing Address - Street 2:BLDG 7, SUITE 400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-4950
Mailing Address - Country:US
Mailing Address - Phone:918-949-9898
Mailing Address - Fax:918-728-8091
Practice Address - Street 1:4606 E. 67TH ST.
Practice Address - Street 2:BLDG 7, SUITE 400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-4950
Practice Address - Country:US
Practice Address - Phone:918-949-9898
Practice Address - Fax:918-728-8091
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2020-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA126192207W00000X
OK30841207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200589260BMedicaid
CA0A126192Medicaid