Provider Demographics
NPI:1558330035
Name:TING, CANDY NGIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:CANDY
Middle Name:NGIAM
Last Name:TING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2615
Mailing Address - Country:US
Mailing Address - Phone:918-574-0350
Mailing Address - Fax:918-574-0359
Practice Address - Street 1:4408 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2615
Practice Address - Country:US
Practice Address - Phone:918-574-0350
Practice Address - Fax:918-574-0359
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100045660AMedicaid
OK278775YLV0Medicare PIN
OK100045660AMedicaid