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Individual

GANNAVARAPU V MURTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1201 E JACKSON ST, HUGO RURAL HEALTH CLINIC, HUGO, OK 74743
(580) 326-6423
(580) 326-3660
Mailing address
603 N.E. 2ND ST., ANTLERS, OK 74523
(580) 298-3351
(580) 298-3803

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13831
OK
207R00000X
Internal Medicine Physician
13831
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100521610B
OK
Enumeration date
11/10/2005
Last updated
04/17/2012
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