Provider Demographics
NPI:1386785582
Name:GOTTIPATI, RANJANA (MBBS, MD)
Entity type:Individual
Prefix:DR
First Name:RANJANA
Middle Name:
Last Name:GOTTIPATI
Suffix:
Gender:F
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 NE 97TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2825 PARKLAWN DRIVE
Practice Address - Street 2:MIDWEST REGION MEDICAL CENTER
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-5020
Practice Address - Country:US
Practice Address - Phone:405-610-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24435207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology