Individual
DR. JACK GAUNG-SHI KAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10014 SE 1138 AVE, TALIHINA, OK 74571
(918) 567-2251
Mailing address
10014 SE 1138 AVE, TALIHINA, OK 74571
(918) 567-2251
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
15992
OK
208D00000X
General Practice Physician
15992
OK
208M00000X
Hospitalist Physician
Primary
15992
OK
Other
Enumeration date
01/23/2008
Last updated
08/11/2010
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