Organization
IVANKA A. VASSILEVA, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVANKA A. VASSILEVA M.D. (OWNER)
(580) 354-9600
Entity
Organization
Contact information
Practice address
4411 W GORE BLVD, SUITE B-10, LAWTON, OK 73505-5977
(580) 354-9600
(580) 354-9621
Mailing address
4411 W GORE BLVD, SUITE B-10, LAWTON, OK 73505-5977
(580) 354-9600
(580) 354-9621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22970
OK
Other
Enumeration date
10/10/2007
Last updated
02/09/2012
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