Individual
SHERYL EVONE GHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
301 J T STITES BLVD, SALLISAW, OK 74955-9302
(918) 775-9150
Mailing address
5831 EUPER LN, FORT SMITH, AR 72903-3239
(479) 629-6125
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3197
OK
208000000X
Pediatrics Physician
E0744
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1203197
—
OK
05
—
129484001
—
AR
01
—
8ED012
MCB-SALLISAW
—
Enumeration date
05/12/2006
Last updated
05/16/2008
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