Provider Demographics
NPI:1699080473
Name:AZADI, CAROL NAHID (DO)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:NAHID
Last Name:AZADI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 NE 1ST ST
Mailing Address - Street 2:APT 202
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4025
Mailing Address - Country:US
Mailing Address - Phone:918-698-2923
Mailing Address - Fax:
Practice Address - Street 1:221 NE 1ST ST APT 202
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4064
Practice Address - Country:US
Practice Address - Phone:918-698-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4879207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine