Basic Information
| Provider Information | |||||||||
| NPI: | 1124160056 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANUPA KHASTGIR MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3366 NW EXPRESSWAY ST | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731124462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059420794 | ||||||||
| FaxNumber: | 4059480537 | ||||||||
| Practice Location | |||||||||
| Address1: | 3366 NW EXPRESSWAY ST | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731124462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059420794 | ||||||||
| FaxNumber: | 4059480537 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4053734340 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 18132 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.