Ivanka A. Vassileva, M.d., P.c.

NPI 1245428630 - Family Medicine - 207Q00000X

NPI Details
NPI 1245428630
Enumeration Date 10/10/2007
Last Updated 02/09/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name IVANKA A. IVANKA
Position OWNER
Phone (580) 354-9600
Fax (580) 354-9621
Practice Location
4411 W GORE BLVD
SUITE B-10
LAWTON OK, 73505-5977, US
Phone (580) 354-9600
Fax (580) 354-9621
Business Location
4411 W GORE BLVD
SUITE B-10
LAWTON OK, 73505-5977, US
Phone (580) 354-9600
Fax (580) 354-9621
Toxanomy
Taxonomy Code 207Q00000X
License State Oklahoma
License Number 22970
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According to our database, Ivanka A. Vassileva, M.d., P.c. NPI is 1245428630, taxonomy code is 207Q00000X and license number is 22970, license state is located at Oklahoma. Ivanka A. Vassileva, M.d., P.c. physically located at 4411 W Gore Blvd, Lawton OK, 73505-5977. NPI Number 1033115704 has the healthcare provider type.

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1245428630 NPI number is provided on an as is basis without warranty of any kind. 1245428630 is maintained by the National Plan & Provider Enumeration System. The contents of Ivanka A. Vassileva, M.d., P.c. are for informational purposes only.