Individual
KALA R MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 N FLORENCE AVE, SUITE 201, CLAREMORE, OK 74017-3179
(918) 343-2728
(918) 343-0783
Mailing address
PO BOX 368, CLAREMORE, OK 74018-0368
(918) 343-2728
(918) 343-0783
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
18536
OK
207RC0000X
Cardiovascular Disease Physician
E3856
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100051980A
—
OK
05
—
150903001
—
AR
Enumeration date
10/04/2005
Last updated
01/28/2011
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