NPI 1902513682 · live from the CMS NPI Registry
Raoul J K Acha, PA
Physician Assistant in Shawnee, OK. National Provider Identifier 1902513682, active.
NPI record
| NPI | 1902513682 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1102 W Macarthur St, Shawnee, OK 74804 |
| Practice phone | 405-273-2270 |
| Mailing address | 12717 Quaker Dr, Oklahoma City, OK 73120 |
| Enumerated | November 1, 2022 |
| Last updated | December 13, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical | 363AM0700X | 4883 (OK) |
| Physician Assistant primary | 363A00000X | 4883 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.