Individual
JO ELLEN COLDIRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 FAIRVIEW AVE, STE 50 OUTPATIENT SURGICAL CTR, PONCA CITY, OK 74601-1920
(580) 765-0673
Mailing address
PO BOX 2005, PONCA CITY, OK 74602-2005
(580) 765-0673
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14761
OK
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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