Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 18439 | OK |
NPI | 1083658447 |
---|---|
Provider Name | Dr. Mahmood Hussain Khichi |
First Address | Tulsa, OK 74136-3347 |
Second Address | Tulsa, OK 74136-1902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 23/03/2011 |