Muskogee Digestive Center Inc | |
384 S 33rd St Suite B Muskogee OK 74401-5065 | |
(918) 682-0700 | |
(918) 682-7317 |
Full Name | Muskogee Digestive Center Inc |
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Speciality | Internal Medicine |
Location | 384 S 33rd St, Muskogee, Oklahoma |
Authorized Official Name and Position | Ajay K Sangal (OWNER) |
Authorized Official Contact | 9186820700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Muskogee Digestive Center Inc 384 S 33rd St Suite B Muskogee OK 74401-5065 Ph: (918) 682-0700 | Muskogee Digestive Center Inc 384 S 33rd St Suite B Muskogee OK 74401-5065 Ph: (918) 682-0700 |
NPI Number | 1811971153 |
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Provider Enumeration Date | 11/30/2005 |
Last Update Date | 08/03/2012 |
Medicare PECOS PAC ID | 8123289873 |
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Medicare Enrollment ID | O20120405000553 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811971153 | NPI | - | NPPES |
100744750A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Ajay K Sangal |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1770579989 PECOS PAC ID: 9931120342 Enrollment ID: I20140529001318 |
Provider Name | Jaquita Y Gardner |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1134635469 PECOS PAC ID: 0941561625 Enrollment ID: I20180220001418 |
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