Individual
VINODH JEEVANANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 S DOUGLAS BLVD, SUITE 200, OKLAHOMA CITY, OK 73150-1001
(405) 737-7000
(405) 272-2898
Mailing address
3400 S DOUGLAS BLVD, SUITE 200, OKLAHOMA CITY, OK 73150-1001
(405) 737-7000
(405) 272-2898
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30512
OK
208M00000X
Hospitalist Physician
2007-01011
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145HT
BCBS
NC
01
—
199206
MEDCOST
NC
05
—
1992885545
—
VA
05
—
200545090A
—
OK
05
—
3810009020
—
WV
05
—
5906676
—
NC
01
—
810599
PARTNERS
NC
01
—
9164064
AETNA
NC
05
—
Q0052M
—
SC
Enumeration date
02/05/2007
Last updated
10/26/2020
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