Organization
SUBRAMANIAM KRISHNAMURTHI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANNA NENA (PRACTICE MANAGER)
(918) 227-3914
Entity
Organization
Contact information
Practice address
114 S MISSION ST, SAPULPA, OK 74066-4637
(918) 227-3914
(918) 227-3922
Mailing address
114 S MISSION ST, SAPULPA, OK 74066-4637
(918) 227-3914
(918) 227-3922
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100248510A
—
OK
Enumeration date
03/08/2019
Last updated
03/08/2019
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