Healthcare Provider Details
I. General information
NPI: 1295901692
Provider Name (Legal Business Name): YURI CHUN LANSINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/06/2008
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 NE 10TH ST OUPB 1C
OKLAHOMA CITY OK
73104-5417
US
IV. Provider business mailing address
PO BOX 26901 DEPT OF ORTHOPEDIC SURGERY AND REHABILITATION
OKLAHOMA CITY OK
73126-0901
US
V. Phone/Fax
- Phone: 405-271-2663
- Fax: 405-271-3074
- Phone: 405-271-4426
- Fax: 405-271-3074
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MT190638 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MD444632 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 29876 |
| License Number State | OK |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | 29876 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: