Basic Information
| Provider Information | |||||||||
| NPI: | 1295901692 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANSINGER | ||||||||
| FirstName: | YURI | ||||||||
| MiddleName: | CHUN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CHUN | ||||||||
| OtherFirstName: | YURI | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 26901 | ||||||||
| Address2: | DEPT OF ORTHOPEDIC SURGERY AND REHABILITATION | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731260901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052714426 | ||||||||
| FaxNumber: | 4052713074 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 NE 10TH ST | ||||||||
| Address2: | OUPB 1C | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052712663 | ||||||||
| FaxNumber: | 4052713074 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2008 | ||||||||
| LastUpdateDate: | 09/09/2014 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MT190638 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD444632 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 29876 | OK | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | 29876 | OK | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.