Organization
ICARE CENTER CHANDLER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SENTHIL K RAJU MD (PROVIDER)
(405) 682-8383
Entity
Organization
Contact information
Practice address
200 PRAIRE LANE, CHANDLER, OK 74834
(405) 682-8383
(405) 265-5230
Mailing address
PO BOX 610, CANUTE, OK 73626-0610
(405) 682-8383
(405) 265-5230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2019
Last updated
08/09/2019
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