Provider Demographics
NPI:1013077130
Name:SAIDI, JOHNAQA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHNAQA
Middle Name:
Last Name:SAIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 S PENNSYLVANIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6909
Mailing Address - Country:US
Mailing Address - Phone:405-691-4497
Mailing Address - Fax:405-692-8807
Practice Address - Street 1:9220 S PENNSYLVANIA AVE STE A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6909
Practice Address - Country:US
Practice Address - Phone:405-691-4497
Practice Address - Fax:405-692-8807
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100188790CMedicaid
OK100188790CMedicaid