GEETHA BHAVANI KANDIMALA (NPI# 1922200435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922200435 |
| Entity Type | Individual |
| Full Name | GEETHA BHAVANI KANDIMALA |
| Credential | MD |
| Practice Address |
5606 Sw Lee Blvd 302 Lawton OK 73505-9688 |
| Practice Telephone | 5809195361 |
| Mailing Telephone | 5809195361 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2012-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
26013 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200199360A | 05 | |
| INSTITUTIONAL PERMIT | BP1-0017760 | 01 |
| Street Address |
5606 SW LEE BLVD 302 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-9688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396854824 | David Paul Vogel | Specialist | 5606 Sw Lee Blvd, Suite 306, Lawton, OK 73505-9688 | 2006-08-29 |
| 1922369701 | Geetha B Kandimala Md PC | Clinic/Center | 5606 Sw Lee Blvd, 302, Lawton, OK 73505-9688 | 2012-06-07 |
| 1407126576 | Brett James Wagner | Optometrist | 5606 Sw Lee Blvd, Suite 301, Lawton, OK 73505-9688 | 2012-01-06 |
| 1609181239 | Folake Esther Olaosebikan | Pediatrics | 5606 Sw Lee Blvd, Suite 201, Lawton, OK 73505-9688 | 2010-08-06 |
| 1780904987 | Kristie Marie Mason | Family Medicine | 5606 Sw Lee Blvd, Suite 303, Lawton, OK 73505-9688 | 2010-06-10 |
| 1245568609 | Southwestern Pulmonary and Critical Care Pllc | Internal Medicine | 5606 Sw Lee Blvd, Suite 304, Lawton, OK 73505-9688 | 2009-11-24 |
| 1134455074 | Southwestern Pediatrics LLC | Pediatrics | 5606 Sw Lee Blvd, Suite 201, Lawton, OK 73505-9688 | 2009-10-28 |
| 1174777940 | Atkinson Medical | Family Medicine | 5606 Sw Lee Blvd, Suite 305, Lawton, OK 73505-9688 | 2008-11-06 |
| 1275783623 | Daniel Constance, M.d. Pllc | Clinic/Center | 5606 Sw Lee Blvd, Suite 203, Lawton, OK 73505 | 2008-09-23 |
| 1730347543 | Lawton Center for Health | Family Medicine | 5606 Sw Lee Blvd, Suite 301, Lawton, OK 73505 | 2008-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497984264 | Farhat Husain, M.d., PC | Psychiatry & Neurology | 4221 S Western Ave, Suite 5000, Oklahoma City, OK 73109-3447 | 2009-07-14 |
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| 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.