Organization
T FAZILI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASADUQ FAZILI MD (OWNER/PHYSICIAN)
(405) 307-1000
Entity
Organization
Contact information
Practice address
901 N PORTER AVE, NORMAN, OK 73071-6404
(405) 307-1000
Mailing address
PO BOX 115, NORMAN, OK 73070-0115
(405) 307-1000
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
26464
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200221440A
—
OK
Enumeration date
11/10/2008
Last updated
03/10/2009
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