Individual
MRS. ALZIRA F VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 FAIRVIEW, ST 10, PONCA CITY, OK 74601
(580) 762-7701
(580) 762-6914
Mailing address
400 FAIRVIEW, ST 10, PONCA CITY, OK 74601
(580) 762-7701
(580) 762-6914
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
16081
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100185330A
—
OK
05
—
100187470B
—
KS
Enumeration date
05/05/2006
Last updated
06/03/2008
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