Provider Demographics
NPI:1144242165
Name:FONG H CHEN M.D. & ASSOCIATES INC
Entity Type:Organization
Organization Name:FONG H CHEN M.D. & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHIOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-254-3396
Mailing Address - Street 1:1818 KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2912
Mailing Address - Country:US
Mailing Address - Phone:580-254-3396
Mailing Address - Fax:580-254-5311
Practice Address - Street 1:1818 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2912
Practice Address - Country:US
Practice Address - Phone:580-254-3396
Practice Address - Fax:580-254-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicare ID - Type Unspecified