Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 23724 | OK |
Y | 111NI0900X | Internist | 23724 | OK |
N | 207RG0300X | Geriatric Medicine | 23724 | OK |
N | 207RH0002X | Hospice and Palliative Medicine | 23724 | OK |
NPI | 1295705663 |
---|---|
Provider Name | Dr. Vishal Aggarwal |
First Address | Tulsa, OK 74135-4442 |
Second Address | Tulsa, OK 74135-7413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200026000A | (05) | OK |
H73722 | (02) |