Vassileva, Ivanka A
Vassileva, Ivanka A is an sole proprietor health care provider with primary practice located at 4411 W Gore Blvd Ste B10, Lawton OK 73505-5977. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Vassileva, Ivanka A can be contacted via phone (580) 354-9600.Contact Information
Primary practice address
4411 W Gore Blvd Ste B10
Lawton OK 73505-5977
Phone: (580) 354-9600
Fax: (580) 354-9621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 22970 | Oklahoma |
Profile Details
| NPI number | 1295729929 |
|---|---|
| LBN Legal business name | Vassileva, Ivanka A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 8th, 2005 |
| Last updated | Feb 9th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295729929 | NPPES |
| Oklahoma | MEDICAID | 200055900A |
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