# SULTAN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366676595
- **Authorized official:** DR. MAHA SULTAN M.D. (OWNER)
- **Authorized official phone:** (580) 335-7878

## Contact information

- **Practice address:** 319 E JOSEPHINE AVE, FREDERICK, OK 73542-2220
- **Practice address phone:** (580) 335-7878
- **Practice address fax:** (580) 335-7086
- **Mailing address:** PO BOX 177, 319 EAST JOSEPHINE, FREDERICK, OK 73542-0177
- **Mailing address phone:** (580) 335-7878
- **Mailing address fax:** (580) 335-7086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 18737 | OK | Yes |

## Other

- **Enumeration date:** 05/01/2009
- **Last updated:** 05/01/2009