Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 109720 | MO |
NPI | 1205854015 |
---|---|
Provider Name | Dr. Iftikhar Hussain |
First Address | Tulsa, OK 74136-7049 |
Second Address | Tulsa, OK 74136-7049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 21/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G27099 | (02) |