Healthcare Provider Details

I. General information

NPI: 1699182139
Provider Name (Legal Business Name): EREN CETIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE STE 6A
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

4778 S SCATTERFIELD RD
ANDERSON IN
46013-2908
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6827
  • Fax: 405-271-4488
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number44126
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01078389A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: