Provider Demographics
NPI:1295969889
Name:A. AMIL MD, INC
Entity type:Organization
Organization Name:A. AMIL MD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AZHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-478-5222
Mailing Address - Street 1:2225 SW 59TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73119-7026
Mailing Address - Country:US
Mailing Address - Phone:405-478-5222
Mailing Address - Fax:405-478-5223
Practice Address - Street 1:2225 SW 59TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73119-7026
Practice Address - Country:US
Practice Address - Phone:405-478-5222
Practice Address - Fax:405-478-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12579207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100226600BMedicaid
OK100226600BMedicaid