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Dr. Jaya Prakash Mallela
Student in an Organized Health Care Education/Training Program in Stillwater, Oklahoma
NPI 1407547326

Jaya Prakash Mallela is a Student in an Organized Health Care Education/Training Program based in Edmond, OK. Jaya Prakash Mallela practices in Stillwater, OK. The NPI Number for Jaya Prakash Mallela is 1407547326 and holds a License No. (Oklahoma).

The current practice location address for Jaya Prakash Mallela is 1323 W 6Th Ave, Stillwater, OK and can be reached out via phone at 405-372-1480. You can also correspond with Jaya Prakash Mallela through the mailing address at 4700 KAMRAN CT, EDMOND, OK - 73013-9040 (mailing address contact number: ).

Location: 1323 W 6Th Ave, Stillwater, OK, 73013-9040
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407547326
Provider Name
Jaya Prakash Mallela
Credential
Provider Entity Type
Individual
Gender
Male
Address
1323 W 6Th Ave, Stillwater, OK, 73013-9040
Phone Number
405-372-1480
Fax Number
Provider Enumeration Date
05/19/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1323 W 6Th Ave
City
Stillwater
State
Oklahoma
Zip
74074-4306
Phone Number
405-372-1480
Fax Number
person
Provider Business Mailing Address Details
Address
4700 Kamran Ct
City
Edmond
State
Oklahoma
Zip
73013-9040
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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