Provider Demographics
NPI:1295000560
Name:ABTAHI, KEIVAN (DO)
Entity type:Individual
Prefix:
First Name:KEIVAN
Middle Name:
Last Name:ABTAHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8210
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1992
Practice Address - Country:US
Practice Address - Phone:918-494-6980
Practice Address - Fax:918-494-4573
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2024-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK5343207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery