Provider Demographics
NPI:1598278764
Name:OKLAHOMA CENTER FOR SPINE & PAIN SOLUTIONS PC
Entity Type:Organization
Organization Name:OKLAHOMA CENTER FOR SPINE & PAIN SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHENG - LUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-806-7246
Mailing Address - Street 1:13700 S WESTERN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7006
Mailing Address - Country:US
Mailing Address - Phone:405-806-7246
Mailing Address - Fax:405-703-1583
Practice Address - Street 1:13700 S WESTERN AVE STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7006
Practice Address - Country:US
Practice Address - Phone:405-806-7246
Practice Address - Fax:405-703-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty