Individual
DR. PRABHU D VIJAYVARGIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 E OKLAHOMA AVE STE 208, ENID, OK 73701-5952
(814) 335-0580
Mailing address
PO BOX 3885, ENID, OK 73702-3885
(814) 335-0580
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
26689
OK
207RP1001X
Pulmonary Disease Physician
Primary
26689
OK
Other
Enumeration date
01/16/2007
Last updated
09/23/2024
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