Organization
GLOW PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOKEHE EFFIONG MD (CEO)
(405) 871-5807
Entity
Organization
Contact information
Practice address
1601 SW PARKRIDGE BLVD STE 304, LAWTON, OK 73505-7569
(405) 871-5807
Mailing address
1601 SW PARKRIDGE BLVD STE 304, LAWTON, OK 73505-7569
(405) 871-5807
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811208945
—
OK
Enumeration date
08/24/2023
Last updated
08/24/2023
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