Individual
AJIT KURIEN THARAKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1265 S UTICA AVE, SUITE 300, TULSA, OK 74104-4243
(918) 592-0999
(918) 592-1021
Mailing address
9228 S MINGO RD, SUITE 200, TULSA, OK 74133-5718
(918) 592-0999
(918) 592-1021
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2009011902
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
227200
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
32742
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204512206
—
MO
Enumeration date
05/03/2006
Last updated
04/12/2022
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