PREMAL KHETIA (NPI# 1285667295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285667295 |
| Entity Type | Individual |
| Full Name | PREMAL KHETIA |
| Credential | MD |
| Practice Address |
1023 E Cherry St Suite B Cushing OK 74023-4105 |
| Mailing Address |
1145 S Utica Ave Suite 110 Tulsa OK 74104-4000 |
| Practice Telephone | 9182251165 |
| Practice Fax Number | 9182251953 |
| Mailing Telephone | 9185793825 |
| Mailing Fax Number | 9185791262 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
23518 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1023 E CHERRY ST SUITE B |
| City | CUSHING |
| State | OK |
| Zip Code | 74023-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669623617 | Dayna Lynn Peacock | Respiratory Therapist, Registered | 1023 E Cherry St, Cushing, OK 74023-4105 | 2008-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982069654 | Laneta D Houston | Nurse's Aide | 1700 E Walnut, Cushing, OK 74023 | 2015-12-23 |
| 1306211024 | Deborah Denise Young | Speech-Language Pathologist | 316 N. Steele Ave, Cushing Upper Elementary, Cushing, OK 74023 | 2015-12-07 |
| 1821463647 | Ladawna Shawndrae Hollingshad | Nurse's Aide | 1405 E Moses, Cushing, OK 74023 | 2015-12-04 |
| 1932573094 | Margaret Marie King | Nurse's Aide | 1405 East Moses, Crushing, OK 74023 | 2015-11-30 |
| 1689056509 | Victoria Moran Nash | Counselor | 321 E. Main, Cushing, OK 74023 | 2015-06-27 |
| 1609140755 | Custom Dental of Cushing,pllc | Dentist | 3200 E. Main Street, Cushing, OK 74023 | 2012-03-06 |
| 1487957601 | World Wide Anesthesia Alliance | Nurse Anesthetist, Certified Registered | 2340 E Main, Cimarron Healthcare Center, Cushing, OK 74023 | 2010-12-09 |
| 1043520695 | Cheryl Kelly | Physical Therapist | 2809 E 9th St, Cushing, OK 74023 | 2010-10-18 |
| 1821279746 | Michael A Miller | Counselor | 100 S Jones, Cushing Valley Hope, Cushing, OK 74023 | 2007-11-20 |
| 1881763050 | Mays Drug Stores Inc | Pharmacy | 2110-o East Main, Cushing, OK 74023 | 2006-11-06 |
| Find all providers in zip 74023 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972817054 | Scott P. Reeder | Otolaryngology | 9001 S 101st East Ave Ste 280, Tulsa, OK 74133-5711 | 2010-08-02 |
| 1356674451 | Wendy D Mcconnell | Otolaryngology | 1608 Professional Cir, Yukon, OK 73099-6314 | 2009-09-08 |
| 1578865416 | Patrick Cody Buchanan | Otolaryngology | 800 W Boise Cir, Suite 320, Broken Arrow, OK 74012-4906 | 2010-11-29 |
Please comment or provide details below to improve the information on PREMAL KHETIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.