Provider Demographics
NPI:1164681458
Name:DELMAR GHEEN MD
Entity Type:Organization
Organization Name:DELMAR GHEEN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-682-1443
Mailing Address - Street 1:2000 E 15TH ST
Mailing Address - Street 2:BUILDING 150 SUITE C
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 E 15TH ST
Practice Address - Street 2:BUILDING 150 SUITE C
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6697
Practice Address - Country:US
Practice Address - Phone:405-682-1443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8333208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty