Individual
DR. SUSANNA V. ULAHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
609 VIRGINIA AVE, PONCA CITY, OK 74601-2911
(580) 767-1300
(580) 765-4529
Mailing address
609 VIRGINIA AVE, PONCA CITY, OK 74601-2911
(580) 767-1300
(580) 765-4529
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
30484EFF
OK
207RH0003X
Hematology & Oncology Physician
Primary
30484EFF
OK
207RX0202X
Medical Oncology Physician
30484EFF
OK
Other
Enumeration date
09/29/2008
Last updated
05/15/2015
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