Individual
NAIF NASIRUDDIN MANSURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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