Organization
DIVINE PROSPERITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KISHORE KUMAR MD (OWNER)
(855) 541-2862
Entity
Organization
Contact information
Practice address
1104 E STATE HIGHWAY 152 UNIT 1, MUSTANG, OK 73064-5116
(405) 563-3998
(405) 563-3998
Mailing address
15317 GRAYSON DR, EDMOND, OK 73013-2601
(855) 541-2862
(405) 716-4808
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
25877
OK
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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