Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 18914 | OK |
Y | 207L00000X | Anesthesiologist | 18914 | OK |
N | 207QA0401X | Family Doctor - Addiction Medicine | 18914 | OK |
N | 208D00000X | General Practice Physician | 18914 | OK |
NPI | 1104856749 |
---|---|
Provider Name | Dr. Paul Powen Cheng |
First Address | Enid, OK 73701-3826 |
Second Address | Enid, OK 73701-3826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 22/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F93215 | (02) | OK |