Organization
ENID LUNG & KIDNEY CLINIC PLLC
Active
Organization
ENID LUNG & KIDNEY CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRABHU D VIJAYVARGIYA M.D. (OWNER)
(580) 233-0595
Entity
Organization
Contact information
Practice address
312 E OWEN K GARRIOTT RD, ENID, OK 73701-5712
(580) 233-0595
(580) 234-1968
Mailing address
PO BOX 3885, ENID, OK 73702-3885
(580) 233-0595
(580) 234-1968
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
03/10/2009
Last updated
03/11/2022
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