Provider Demographics
NPI:1659678340
Name:ELLEN E HOPE M D INC
Entity Type:Organization
Organization Name:ELLEN E HOPE M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLFENKOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-691-0221
Mailing Address - Street 1:PO BOX 20240
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73156-0240
Mailing Address - Country:US
Mailing Address - Phone:405-270-0500
Mailing Address - Fax:405-270-0597
Practice Address - Street 1:125 E 3RD ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3821
Practice Address - Country:US
Practice Address - Phone:405-270-0500
Practice Address - Fax:405-270-0597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK126892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK567821153Medicare PIN