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Individual

CLELL W POND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
8801 S 101ST EAST AVE, TULSA, OK 74133-5716
(918) 294-4000
Mailing address
PO BOX 5358, NORMAN, OK 73070-5358
(866) 321-8433

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
3484
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100096560C
OK
Enumeration date
01/19/2006
Last updated
07/08/2007
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