Provider Demographics
NPI:1164508750
Name:GO, PATRICE U (MD)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:U
Last Name:GO
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 1:11100 HEFNER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5049
Mailing Address - Country:US
Mailing Address - Phone:405-749-0415
Mailing Address - Fax:405-749-6853
Practice Address - Street 1:11100 HEFNER POINTE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5049
Practice Address - Country:US
Practice Address - Phone:405-749-0415
Practice Address - Fax:405-749-6853
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine