Organization
DIALYSIS SPECIALISTS OF SEMINOLE OKLAHOMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHIR KHANNA MD (MEDICAL DIRECTOR)
(405) 382-9809
Entity
Organization
Contact information
Practice address
12581 NS 3540 CR, SEMINOLE, OK 74868-9789
(405) 382-9809
(405) 382-7911
Mailing address
12581 NS 3540 CR, SEMINOLE, OK 74868-9789
(405) 382-9809
(405) 382-7911
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000129908
—
OK
Enumeration date
11/29/2006
Last updated
11/25/2008
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