Individual
PREMAL KHETIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1023 E CHERRY ST, SUITE B, CUSHING, OK 74023-4105
(918) 225-1165
(918) 225-1953
Mailing address
1145 S UTICA AVE, SUITE 110, TULSA, OK 74104-4000
(918) 579-3825
(918) 579-1262
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
23518
OK
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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