Individual
GEETHA BHAVANI KANDIMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2821 36TH AVE NW STE 200, NORMAN, OK 73072-2477
(405) 307-5700
Mailing address
2709 WARWICK PL, EDMOND, OK 73013-6553
(580) 919-5361
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
26013
OK
2084N0600X
Clinical Neurophysiology Physician
Primary
26013
OK
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
26013
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200199360A
—
OK
01
—
BP1-0017760
INSTITUTIONAL PERMIT
—
Enumeration date
06/05/2007
Last updated
03/03/2026
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