Healthcare Provider Details

I. General information

NPI: 1134454747
Provider Name (Legal Business Name): YU-FAN ZHANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2009
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 E 15TH ST STE 102
TULSA OK
74104-5242
US

IV. Provider business mailing address

2811 E 15TH ST STE 102
TULSA OK
74104-5242
US

V. Phone/Fax

Practice location:
  • Phone: 918-935-3240
  • Fax: 918-935-3241
Mailing address:
  • Phone: 918-935-3240
  • Fax: 918-935-3241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD447692
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA107667
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number261727
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number37103
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: