Individual
GEORGE PASSION QUEJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 E JACKSON ST, HUGO, OK 74743
(580) 326-6423
(580) 326-3660
Mailing address
PO BOX 876, ANTLERS, OK 74523-2636
(580) 298-3351
(580) 298-3803
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14309
OK
208600000X
Surgery Physician
G 6598
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10008770D
—
OK
Enumeration date
11/03/2005
Last updated
04/17/2012
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