# SALLY Q TAN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437456225
- **Authorized official:** DR. SALLY Q. TAN M.D. (PRESIDENT)
- **Authorized official phone:** (405) 319-1622

## Contact information

- **Practice address:** 1110 N CLASSEN BLVD, SUITE 204, OKLAHOMA CITY, OK 73106-6843
- **Practice address phone:** (405) 319-1622
- **Practice address fax:** (405) 319-1575
- **Mailing address:** 1110 N CLASSEN BLVD, SUITE 204, OKLAHOMA CITY, OK 73106-6843
- **Mailing address phone:** (405) 319-1622
- **Mailing address fax:** (405) 319-1575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 19992 | OK | Yes |

## Other

- **Enumeration date:** 02/14/2011
- **Last updated:** 02/14/2011