Individual
CONRAD CHESNUT CALDWELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4300 W MEMORIAL RD, ER DEPT., OKLAHOMA CITY, OK 73120-8304
(405) 752-3733
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
22805
OK
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
22805
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100211220A
—
OK
05
—
100211220B
—
OK
01
—
930119846
RR MEDICARE
OK
01
—
930126932
RR MEDICARE
OK
Enumeration date
03/30/2006
Last updated
06/24/2024
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