Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 117899 | MO |
N | 208600000X | Surgeon | 117899 | MO |
N | 2086S0120X | Pediatric Surgery | 117899 | MO |
Y | 2086S0120X | Pediatric Surgery | 28432 | OK |
NPI | 1134296577 |
---|---|
Provider Name | Dr. Edward G. Ford |
First Address | Tulsa, OK 74136-3347 |
Second Address | Tulsa, OK 74136-1907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 27/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200335580A | (05) | OK |
2038833400 | (05) | MO |
D75181 | (02) | MO |