Individual
DR. GEORGE N CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8224 SILVER XING, OKLAHOMA CITY, OK 73132-3375
(405) 722-4645
Mailing address
2714 LAMOND HILL AVE, EDMOND, OK 73034-6979
(405) 722-4645
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
17461
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100827610A
—
OK
01
—
360004269
RAILROAD MEDICARE
—
Enumeration date
02/13/2007
Last updated
03/05/2021
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