Provider Demographics
NPI:1386640951
Name:YOUKHANA, KELLEE (MD)
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:
Last Name:YOUKHANA
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 1:3330 NW 56TH ST
Mailing Address - Street 2:STE 312
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4479
Mailing Address - Country:US
Mailing Address - Phone:405-602-3553
Mailing Address - Fax:405-602-3556
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:STE 312
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4479
Practice Address - Country:US
Practice Address - Phone:405-602-3553
Practice Address - Fax:405-602-3556
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19829207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H09788Medicare UPIN