1588183073 NPI number — MR. HIROSHI NAKAGAWA M.D., PH.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588183073 NPI number — MR. HIROSHI NAKAGAWA M.D., PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAKAGAWA
Provider First Name:
HIROSHI
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588183073
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 EVERETT DRIVE
Provider Second Line Business Mailing Address:
TCH 6E103
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73104-5068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-271-9696
Provider Business Mailing Address Fax Number:
405-271-7455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 EVERETT DRIVE
Provider Second Line Business Practice Location Address:
TCH 6E103
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73104-5068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-271-9696
Provider Business Practice Location Address Fax Number:
405-271-7455
Provider Enumeration Date:
09/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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