Provider Demographics
NPI:1750540993
Name:K.ASHOK MD,PC
Entity type:Organization
Organization Name:K.ASHOK MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNAMUURTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-209-2940
Mailing Address - Street 1:1211 N SHARTEL AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1211 N SHARTEL AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2400
Practice Address - Country:US
Practice Address - Phone:405-209-2940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24186261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care