Healthcare Provider Details
I. General information
NPI: 1457344111
Provider Name (Legal Business Name): Y.C. CHOO, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2005
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3020 S HARVARD AVE SUITE C
TULSA OK
74114-6126
US
IV. Provider business mailing address
3020 S HARVARD AVE SUITE C
TULSA OK
74114-6126
US
V. Phone/Fax
- Phone: 918-747-6100
- Fax: 918-747-0402
- Phone: 918-747-6100
- Fax: 918-747-0402
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 14935 |
| License Number State | OK |
VIII. Authorized Official
Name: DR.
YEW
CHEONG
CHOO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 918-747-6100