Provider Demographics
NPI:1467689596
Name:CLASSEN MEDICAL CENTER PLLC
Entity Type:Organization
Organization Name:CLASSEN MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOPRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-236-3736
Mailing Address - Street 1:1110 N CLASSEN BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6843
Mailing Address - Country:US
Mailing Address - Phone:405-236-3736
Mailing Address - Fax:405-236-2137
Practice Address - Street 1:1110 N CLASSEN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6843
Practice Address - Country:US
Practice Address - Phone:405-236-3736
Practice Address - Fax:405-236-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22631207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty