Individual
VYJAYANTHI GANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 E 19TH ST, EDMOND, OK 73013-6618
(405) 348-6611
(405) 348-9280
Mailing address
920 STANTON L YOUNG BLVD # 2410, OKLAHOMA CITY, OK 73104-5036
(405) 348-6611
(405) 348-9280
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37928
OK
207R00000X
Internal Medicine Physician
E-8075
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201010001
—
AR
Enumeration date
09/16/2009
Last updated
03/14/2022
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