Individual
KAMRAN MOHAJER MASSOUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 N MAIN ST, ELK CITY, OK 73644-2831
(580) 225-1555
(580) 225-1558
Mailing address
1020 N MAIN ST, ELK CITY, OK 73644-2831
(580) 225-1555
(580) 225-1558
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23117
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171274701
—
TX
05
—
200015260A
—
OK
01
—
2386811
UNITED HEALTHCARE
OK
01
—
7072482
AETNA
OK
Enumeration date
05/24/2005
Last updated
04/26/2024
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