Basic Information
| Provider Information | |||||||||
| NPI: | 1871684464 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KATHARANI | ||||||||
| FirstName: | PADMANI | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | KATHARANI | ||||||||
| OtherFirstName: | PAM | ||||||||
| OtherMiddleName: | K. | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 100 S BLISS AVE | ||||||||
| Address2: | |||||||||
| City: | TAHLEQUAH | ||||||||
| State: | OK | ||||||||
| PostalCode: | 744642512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184583360 | ||||||||
| FaxNumber: | 9184583511 | ||||||||
| Practice Location | |||||||||
| Address1: | 921 NE 13TH ST | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054565000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 18716 | NE | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 18716 | NE | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.