Individual
IKUYO YAMAGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-4211
Mailing address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-4211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00041921
WA
2080P0210X
Pediatric Nephrology Physician
MD00041921
WA
2080P0210X
Pediatric Nephrology Physician
Primary
P8827
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331948501
—
TX
Enumeration date
08/30/2006
Last updated
02/24/2021
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