MEDICARE: DR. LLOYD ROBERT CHANCE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	3249	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5747142	OTHER	OK	AETNA
2	721545605-001	OTHER	OK	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174518575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LLOYD ROBERT CHANCE D.O.

Provider Business Mailing Address
First Line	:	608 NW 9TH ST STE 6210
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1069
Country	:	US
Telephone Number	:	405-272-9641
Fax Number	:	405-235-0738

Provider Business Practice Location Address
First Line	:	1800 RENAISSANCE BLVD
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-3023
Country	:	US
Telephone Number	:	405-359-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	01/03/2023

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