Provider Demographics
NPI:1801888441
Name:SEHGAL, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SEHGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E VAN BUREN AVE
Mailing Address - Street 2:PO BOX 908
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4245
Mailing Address - Country:US
Mailing Address - Phone:918-421-8446
Mailing Address - Fax:918-423-4051
Practice Address - Street 1:1401 E VAN BUREN AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74502
Practice Address - Country:US
Practice Address - Phone:918-421-8446
Practice Address - Fax:918-423-4051
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK24851207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00327742Medicare PIN
H54842Medicare UPIN