Provider Demographics
NPI:1306966007
Name:NAROTAM, SANJAY K (MD)
Entity type:Individual
Prefix:
First Name:SANJAY
Middle Name:K
Last Name:NAROTAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 NW 50TH ST
Mailing Address - Street 2:SUITE 276W
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8046
Mailing Address - Country:US
Mailing Address - Phone:405-486-7255
Mailing Address - Fax:706-653-8732
Practice Address - Street 1:901 N PORTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6404
Practice Address - Country:US
Practice Address - Phone:405-307-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000413182085R0202X
TXM95292085R0202X
ARE-49382085R0202X
MS187232085R0202X
OK269312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196475102OtherCSHCN
TX8AL155OtherBCBSTX
TX196475101Medicaid
TX8K8402Medicare PIN
TX196475101Medicaid