Sopukro W Tienabeso M.D.

NPI 1770513442 - Internal Medicine - 207R00000X

NPI Details
NPI 1770513442
Gender Male
Enumeration Date 07/05/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1 E CLARK BASS BLVD
MCALESTER OK, 74501-4209, US
Phone (918) 426-1800
Fax
Business Location
1316 NW 170TH ST
EDMOND OK, 73003-7410, US
Phone (405) 285-0796
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Oklahoma
License Number 24308
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According to our database, Sopukro W Tienabeso M.D. NPI is 1770513442, taxonomy code is 207R00000X and license number is 24308, license state is located at Oklahoma. Sopukro W Tienabeso M.D. physically located at 1 E Clark Bass Blvd, Mcalester OK, 74501-4209. NPI Number Sopukro W Tienabeso M.D. has the Individual type.

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1770513442 NPI number is provided on an as is basis without warranty of any kind. 1770513442 is maintained by the National Plan & Provider Enumeration System. The contents of Sopukro W Tienabeso M.D. are for informational purposes only.