Healthcare Provider Details

I. General information

NPI: 1437378478
Provider Name (Legal Business Name): BOBBY C. KANG, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 W OWEN K GARRIOTT RD
ENID OK
73703-5221
US

IV. Provider business mailing address

2426 W OWEN K GARRIOTT RD
ENID OK
73703-5221
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-7600
  • Fax: 580-233-7661
Mailing address:
  • Phone: 580-233-7600
  • Fax: 580-233-7661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BOBBY CHU KANG
Title or Position: PRESIDENT
Credential: D.O.
Phone: 580-233-7600