Individual
KEVIN M CHESSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 749-7099
Mailing address
4401 W MEMORIAL RD, 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1576
OK
Other
Enumeration date
01/29/2007
Last updated
05/27/2014
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