Individual
KEITH KURT FISCHBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 N LEE AVE, OKLAHOMA CITY, OK 73102-1036
(405) 272-6154
Mailing address
4502 E 41ST ST, DEPARTMENT OF EMERGENCY MEDICINE, TULSA, OK 74135-9923
(918) 660-3505
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27723
OK
390200000X
Student in an Organized Health Care Education/Training Program
27723
OK
Other
Enumeration date
04/15/2010
Last updated
12/27/2018
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