Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 17462 | OK |
N | 213ES0000X | Sports Medicine | 17462 | OK |
N | 2081S0010X | Sports Medicine | 24746 | TN |
N | 213ES0000X | Sports Medicine | 24746 | TN |
NPI | 1043373533 |
---|---|
Provider Name | Val Gene Iven |
First Address | Stillwater, OK 74078 |
Second Address | Stillwater, OK 74078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 09/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F13752 | (02) |