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General NPI Number Information
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NPI Number | 1093260994
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR INSTITUTE OF EXCELLENCE PLLC
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Dates
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Enumeration Date | 08/20/2016
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Last Update Date | 08/20/2016
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Provider Practice Location Address
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Address Line | 1202 W CHEROKEE ST SUITE B
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City | WAGONER
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State | OK
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Zip | 74467-4629
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Country | US
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Telephone | 918-485-1326
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Fax | 918-512-4021
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Provider Business Mailing Address
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Address Line | 1202 W CHEROKEE ST SUITE B
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City | WAGONER
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State | OK
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Zip | 74467-4629
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Country | US
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Telephone | 918-485-1326
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Fax | 918-512-4021
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA MCGEE
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Credential | D. O.
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Telephone | 918-485-1326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4836
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License Number State | OK
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