MEDICARE: DR. BENNIE FRANK CHEEK DO

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	207Q00000X	Family Medicine Physician	2512	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386634905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENNIE FRANK CHEEK DO

Provider Business Mailing Address
First Line	:	710 E SHAWNTEL SMITH BLVD
Second Line	:	SUITE B
City	:	MULDROW
State	:	OK
Zip	:	74948-4830
Country	:	US
Telephone Number	:	918-427-3294
Fax Number	:	918-427-1137

Provider Business Practice Location Address
First Line	:	710 E SHAWNTEL SMITH BLVD
Second Line	:	SUITE B
City	:	MULDROW
State	:	OK
Zip	:	74948
Country	:	US
Telephone Number	:	918-427-3294
Fax Number	:	918-427-1137

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	06/03/2008

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