Organization
WESTERN OKLAHOMA ENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHENG H PAN MD (PHYSICIAN OWNER)
(580) 225-5365
Entity
Organization
Contact information
Practice address
1710 W 3RD ST, SUITE 102, ELK CITY, OK 73644-5159
(580) 225-5365
(580) 225-2174
Mailing address
1710 W 3RD ST, SUITE 102, ELK CITY, OK 73644-5159
(580) 225-5365
(580) 225-2174
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
24331
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE9071
RAILROAD MEDICARE
OK
Enumeration date
12/20/2006
Last updated
09/24/2007
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