Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5087 | OK |
NPI | 1073622189 |
---|---|
Provider Name | Dr. Christopher Kenny Templeton IV |
First Address | Edmond, OK 73034-3822 |
Second Address | Edmond, OK 73034-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 14/02/2020 |