Individual
ELIZA FARMER CHAKRAVARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 NE 15TH ST, OKLAHOMA CITY, OK 73104-4602
(405) 271-6242
(405) 271-2887
Mailing address
PO BOX 268900, OKLAHOMA CITY, OK 73126-8900
(405) 271-6242
(405) 271-2887
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A66676
CA
207RR0500X
Rheumatology Physician
Primary
28540
OK
207RR0500X
Rheumatology Physician
A66676
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A666760
—
CA
Enumeration date
04/13/2006
Last updated
09/29/2011
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