Individual
BAOLONG DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 MEDICAL DR, GUYMON, OK 73942-3606
(580) 338-3361
(580) 338-1021
Mailing address
PO BOX 1340, LIBERAL, KS 67905-1340
(620) 629-6638
(620) 629-6684
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
134792
OK
363LF0000X
Family Nurse Practitioner
53-79076-102
KS
Other
Enumeration date
10/21/2019
Last updated
12/27/2019
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