Provider Demographics
NPI:1033436605
Name:IONAN, CONSTANTINE EDWARD (SA-C)
Entity Type:Individual
Prefix:
First Name:CONSTANTINE
Middle Name:EDWARD
Last Name:IONAN
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SL YOUNG BLVD # WP2230
Mailing Address - Street 2:CVT SURGERY
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5036
Mailing Address - Country:US
Mailing Address - Phone:405-271-8000
Mailing Address - Fax:
Practice Address - Street 1:920 SL YOUNG BLVD # WP2230
Practice Address - Street 2:CVT SURGERY
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5036
Practice Address - Country:US
Practice Address - Phone:405-271-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant