Individual
MADHULIKA KRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4318 W OKMULGEE ST, MUSKOGEE, OK 74401-4648
(918) 686-0471
(918) 686-9471
Mailing address
4318 W OKMULGEE ST, MUSKOGEE, OK 74401-4648
(918) 686-0471
(918) 686-9471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30460
OK
207Q00000X
Family Medicine Physician
E3302
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100850740A
—
OK
01
—
100850740C
SOONER CARE
OK
05
—
146877001
—
AR
01
—
5M288
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/20/2005
Last updated
10/20/2017
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