Provider Demographics
NPI:1548390628
Name:NARAYANA PAI MD PC
Entity type:Organization
Organization Name:NARAYANA PAI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARAYANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-216-5357
Mailing Address - Street 1:105 S BRYANT AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6331
Mailing Address - Country:US
Mailing Address - Phone:405-216-5357
Mailing Address - Fax:405-285-4397
Practice Address - Street 1:105 S BRYANT AVE STE 400
Practice Address - Street 2:EDMOND REGIONAL MEDICAL BLDG.
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6331
Practice Address - Country:US
Practice Address - Phone:405-216-5357
Practice Address - Fax:405-285-4397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK183852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100825050 BMedicaid
F68053Medicare UPIN
400522452Medicare ID - Type Unspecified