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Individual

ROLDON SANCHEZ

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
2002 12TH AVE NW, SUITE B, ARDMORE, OK 73401-1206
(580) 223-4795
(580) 223-5184
Mailing address
1015 S COMMERCE ST, SUITE B, ARDMORE, OK 73401-5018
(580) 223-4795
(580) 223-5184

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA877
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200067040A
OK
01
970010036
RAILROAD MEDICARE
OK
Enumeration date
04/12/2006
Last updated
02/22/2017
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