Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 34350 | OK |
NPI | 1104180553 |
---|---|
Provider Name | Dr. Ajay Joseph |
First Address | Tulsa, OK 74136-3331 |
Second Address | Tulsa, OK 74136-1907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2012 |
Last Update Date | 16/04/2020 |