Healthcare Provider Details
I. General information
NPI: 1497002869
Provider Name (Legal Business Name): YUAN ZHANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/05/2012
Last Update Date: 11/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4418
US
IV. Provider business mailing address
5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US
V. Phone/Fax
- Phone: 405-713-7403
- Fax: 405-713-2794
- Phone: 405-713-7403
- Fax: 405-713-2794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 34952 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 34952 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: