Basic Information
| Provider Information | |||||||||
| NPI: | 1144242165 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FONG H CHEN M.D. & ASSOCIATES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1818 KANSAS AVE | ||||||||
| Address2: | |||||||||
| City: | WOODWARD | ||||||||
| State: | OK | ||||||||
| PostalCode: | 738012912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802543396 | ||||||||
| FaxNumber: | 5802545311 | ||||||||
| Practice Location | |||||||||
| Address1: | 1818 KANSAS AVE | ||||||||
| Address2: | |||||||||
| City: | WOODWARD | ||||||||
| State: | OK | ||||||||
| PostalCode: | 738012912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802543396 | ||||||||
| FaxNumber: | 5802545311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CHIOU | ||||||||
| AuthorizedOfficialFirstName: | HELEN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5802543396 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 11152 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.