| S V Vaidya Md Pc | |
|
400 Fairview Ave Suite 10 Ponca City OK 74601-1920 | |
| (580) 762-7734 | |
| (580) 762-6914 |
| Full Name | S V Vaidya Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 400 Fairview Ave, Ponca City, Oklahoma |
| Authorized Official Name and Position | S V Vaidya (OWNER) |
| Authorized Official Contact | 5807627734 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S V Vaidya Md Pc 400 Fairview Ave Suite 10 Ponca City OK 74601-1920 Ph: (580) 762-7734 | S V Vaidya Md Pc 400 Fairview Ave Suite 10 Ponca City OK 74601-1920 Ph: (580) 762-7734 |
| NPI Number | 1891969325 |
|---|---|
| Provider Enumeration Date | 04/16/2008 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891969325 | NPI | - | NPPES |
| 100206890B | Medicaid | KS | |
| 100185320A | Medicaid | OK | |
| 010998 | Other | KS | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 16078 (Oklahoma) | Primary |
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