Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 24129 | OK |
NPI | 1003956285 |
---|---|
Provider Name | Fazal Akbar Ali |
First Address | Oklahoma City, OK 73109-3445 |
Second Address | Oklahoma City, OK 73109-3447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 23/01/2018 |