Provider Demographics
NPI:1073582896
Name:NORDHUES, ELAINE K (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:K
Last Name:NORDHUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248856
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8856
Mailing Address - Country:US
Mailing Address - Phone:405-607-4520
Mailing Address - Fax:405-607-4525
Practice Address - Street 1:2525 NW EXPRESSWAY
Practice Address - Street 2:SUITE 404
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7230
Practice Address - Country:US
Practice Address - Phone:405-607-4520
Practice Address - Fax:405-607-4525
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK189192085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00261919OtherRAILROAD MEDICARE
OK100096420AMedicaid
OK100096420AMedicaid
243435302Medicare PIN