Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 22531 | OK |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 22531 | OK |
NPI | 1093791741 |
---|---|
Provider Name | Kenneth M Chekofsky |
First Address | Tulsa, OK 74136-3310 |
Second Address | Tulsa, OK 74136-7816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 30/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C60324 | (02) | OK |