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Individual

DAVID HENRI CHANSOLME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4221 S WESTERN AVE, #4010, OKLAHOMA CITY, OK 73109-3447
(405) 644-6464
(405) 644-6465
Mailing address
PO BOX 720486, NORMAN, OK 73070-4357
(405) 292-5500
(405) 292-5505

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
23723
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200033350A
OK
01
P00174725
RAILROAD MEDICARE
OK
Enumeration date
08/16/2005
Last updated
02/04/2015
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