Ivanoff, John G
Ivanoff, John G is an individual health care provider with primary practice located at 10505 E 91St St Suite 208, Tulsa OK 74133-5801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Ivanoff, John G can be contacted via phone (918) 494-8500.Contact Information
Primary practice address
10505 E 91St St Suite 208
Tulsa OK 74133-5801
Phone: (918) 494-8500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 19125 | Oklahoma |
Profile Details
| NPI number | 1497725857 |
|---|---|
| LBN Legal business name | Ivanoff, John G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Jun 13th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497725857 | NPPES |
| Oklahoma | MEDICAID | 100023590A | |
| Oklahoma | Other | 300522262 |
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