Individual
DR. EARL UDO BACHENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1844 E 15TH ST, TULSA, OK 74104-4611
(918) 749-7177
Mailing address
1844 E 15TH ST, TULSA, OK 74104-4611
(918) 749-7177
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
1497
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100018180B
—
OK
Enumeration date
05/03/2006
Last updated
09/29/2008
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