Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 1330-TEP | WI |
N | 111NI0900X | Internist | 1330-TEP | WI |
Y | 207RA0201X | Internist - Allergy & Immunology | D70933 | MD |
NPI | 1174581508 |
---|---|
Provider Name | Laura K. Chong |
First Address | Oklahoma City, OK 73104-5010 |
Second Address | Oklahoma City, OK 73104-5010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 15/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036293000 | (05) | MD |