Individual
MR. JUSTIN COLE CHEEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNP
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 223-0447
(580) 223-2989
Mailing address
2412 S ROCKFORD PKWY, ARDMORE, OK 73401-3021
(580) 465-1885
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
92507
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200750540A
—
OK
Enumeration date
10/12/2017
Last updated
03/07/2018
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