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General NPI Number Information
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NPI Number | 1881689743
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Entity Type | Individual
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Provider Name | GIDEON TOHONG LAU MD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 2220 W IOWA AVE
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City | CHICKASHA
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State | OK
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Zip | 73018-2738
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Country | US
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Telephone | 405-224-2300
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Fax | 405-779-2413
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Provider Business Mailing Address
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Address Line | 2220 W IOWA AVE
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City | CHICKASHA
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State | OK
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Zip | 73018-2738
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Country | US
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Telephone | 405-224-2300
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Fax | 405-779-2122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 11040
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License Number State | OK
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