Organization
QAISAR J QAYYUM MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QAISAR J QAYYUM MD (PRESIDENT)
(405) 562-8715
Entity
Organization
Contact information
Practice address
13974 S BROADWAY, EDMOND, OK 73034-8144
(405) 562-8715
(405) 562-8717
Mailing address
PO BOX 31195, EDMOND, OK 73003
(405) 562-8715
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
21912
OK
Other
Enumeration date
07/20/2006
Last updated
06/22/2020
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