Organization Name: | KIDZCHOICE, PC |
NPI Number: | 1043430077 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CYNTHIA N SANFORD (PRESIDENT) |
Mailing Address: | 101 Oklahoma Ave Mcalester |
State: | OK US |
Postal Code: | 745017508 |
Phone Number: | 9184234900 |
Fax Number: | 9184234905 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | R0062969 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |