Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 13465 | OK |
N | 207RA0201X | Internist - Allergy & Immunology | 13465 | OK |
Y | 207RR0500X | Rheumatology | 13465 | OK |
NPI | 1215906920 |
---|---|
Provider Name | Ira N Targoff |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73104-5417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 16/03/2011 |