Individual
JONATHAN DRAKE CHANCELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612
Mailing address
4943 E 103RD ST, TULSA, OK 74137-6053
(918) 299-3633
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11284
OK
Other
Enumeration date
10/03/2005
Last updated
07/23/2010
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