Individual
DR. THEODORE DICKINSON KLUG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
800 STANTON L YOUNG BLVD, OKLAHOMA CITY, OK 73104-5018
(405) 271-5504
Mailing address
6057 BEAU PRE N, MEMPHIS, TN 38120-4101
(901) 491-1721
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
39923
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2021
Last updated
07/07/2022
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