Provider Demographics
NPI:1649554593
Name:LANDGE, VIKRANT LAXMAN (MD)
Entity type:Individual
Prefix:DR
First Name:VIKRANT
Middle Name:LAXMAN
Last Name:LANDGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1401 W LOCUST ST
Mailing Address - Street 2:STE 102
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-3275
Mailing Address - Country:US
Mailing Address - Phone:918-696-4065
Mailing Address - Fax:918-696-5971
Practice Address - Street 1:1401 W LOCUST ST
Practice Address - Street 2:STE 102
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3275
Practice Address - Country:US
Practice Address - Phone:918-696-4065
Practice Address - Fax:918-696-5971
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2015-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL30871207X00000X
NYP91524207X00000X
OK31016207X00000X
ZZ2004021303207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery