Provider Demographics
NPI:1992018253
Name:MAQBOOL, MUHAMMAD QASIM (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:QASIM
Last Name:MAQBOOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8210
Practice Address - Street 1:6475 S YALE AVE STE 308
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7802
Practice Address - Country:US
Practice Address - Phone:918-502-9650
Practice Address - Fax:918-502-9655
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64188207Q00000X, 207Q00000X
WAMD61351065207Q00000X
OK28000208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine