Healthcare Provider Details

I. General information

NPI: 1871112318
Provider Name (Legal Business Name): ELIZABETH YIWEI CHEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 E 81ST ST STE 3700
TULSA OK
74137-4257
US

IV. Provider business mailing address

1322 E 35TH PL
TULSA OK
74105-2651
US

V. Phone/Fax

Practice location:
  • Phone: 918-236-4000
  • Fax:
Mailing address:
  • Phone: 918-605-2434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: