Provider Demographics
NPI:1477696094
Name:JOHN B CHACE MD PC
Entity Type:Organization
Organization Name:JOHN B CHACE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:DUNFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-329-4102
Mailing Address - Street 1:500 E ROBINSON ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071
Mailing Address - Country:US
Mailing Address - Phone:405-329-4102
Mailing Address - Fax:405-364-3476
Practice Address - Street 1:500 E ROBINSON ST STE 2300
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6671
Practice Address - Country:US
Practice Address - Phone:405-329-4102
Practice Address - Fax:405-364-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24274174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty