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Individual

USHA CHANDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4411 W GORE BLVD, SUITE A2, LAWTON, OK 73505
(580) 355-0575
(580) 248-1725
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13927
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080081662
RAILROAD MEDICARE
05
100040430B
OK
05
100040430F
OK
01
5100141
AETNA
OK
Enumeration date
09/21/2005
Last updated
01/29/2009
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