Western Oklahoma ENT, PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

24331 Issued in OK

Legal business name

WESTERN OKLAHOMA ENT, PLLC

Practice address

1710 W 3Rd St
Suite 102
Elk City, OK 73644-5159

Phone

(580) 225-5365

Fax

(580) 225-2174

NPI assigned

Dec 20, 2006

Last updated

Sep 24, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cheng H Pan, MD

Title

Physician Owner

Phone

(580) 225-5365

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1245394949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W 3RD ST",
            "address_2": "SUITE 102",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736445159",
            "telephone_number": "580-225-5365",
            "fax_number": "580-225-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W 3RD ST",
            "address_2": "SUITE 102",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736445159",
            "telephone_number": "580-225-5365",
            "fax_number": "580-225-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN OKLAHOMA ENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "CHENG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "580-225-5365",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "24331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE9071",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Elk City, OK
• Providers in Elk City, OK by specialty
• Otolaryngology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.