Provider Demographics
NPI:1770579989
Name:SANGAL, AJAY KUMAR (MD)
Entity type:Individual
Prefix:MR
First Name:AJAY
Middle Name:KUMAR
Last Name:SANGAL
Suffix:
Gender:M
Credentials:MD
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 1:384 S 33RD ST STE B
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-5065
Practice Address - Country:US
Practice Address - Phone:918-682-0700
Practice Address - Fax:918-682-7317
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2023-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK17431207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731477756001OtherBCBS
OK100061350AMedicaid
OK100002777OtherRRMC
OK100061350AMedicaid