Ajay Bhargava, MD
Individual provider Active NPI Pediatric Gastroenterology Physician · Lawton, OK
NPI 1174624845 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174624845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Gastroenterology Physician 2080P0206X
- License
- 15053 (OK)
- Practice address
- 4302 SW Lee Blvd
Lawton, OK 73505 - Phone
- (580) 357-0058
- Fax
- (580) 248-7667
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090309000222 | OK | Practitioner - Gastroenterology |
7315003803 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ajay Bhargava MD Inc | Pediatric Gastroenterology | Current |
Accepting new patients |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Locations
4302 SW Lee Blvd
Lawton, OK 73505
Phone (580) 357-0058
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 15053 | OK | Yes |
Addresses
Primary practice location
4302 SW Lee Blvd
Lawton, OK 73505
Mailing address
4302 SW Lee Blvd
Lawton, OK 73505
Phone (580) 357-0058
Other providers in Lawton, OK
- Walter Thomas Berry
- Zachary Michael Berry
- Crystal M Berthiaume
- Ronna Deanne Bertram-Davis
- Andrew Bevington
- Shireen Bhargava
- Lindsey Elaine Bickerstaff
- Aila Biesen
- Teresa Biffle
- Brian John Bigelow
All providers in Lawton, OK · Pediatric Gastroenterology Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.