Individual
ERICA R. SUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
905 COLONY DR, ADA, OK 74820-2329
(580) 436-5111
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 421-6283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34-008767
OH
2084P0800X
Psychiatry Physician
Primary
34-008767
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36123
OBNDD LICENSE
OK
01
—
4562
LICENSE
OK
Enumeration date
07/19/2006
Last updated
03/07/2023
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