Individual
DR. COREY E PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13401 N. WESTERN AVE., STE. 301, OKLAHOMA CITY, OK 73114
(405) 478-7111
(405) 478-7112
Mailing address
1110 N LEE AVE STE 200, OKLAHOMA CITY, OK 73103-2612
(405) 218-2530
(405) 218-2535
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
22884
OK
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
22884
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578658035
OKLAHOMA SPORTS AND ORTHOPEDICS INSTITUTE
OK
Enumeration date
02/06/2007
Last updated
06/16/2023
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