Pond, Clell W

Pond, Clell W is an individual health care provider with primary practice located at 8801 S 101St East Ave , Tulsa OK 74133-5716. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Pond, Clell W can be contacted via phone (918) 294-4000.

Contact Information

Primary practice address
8801 S 101St East Ave Tulsa OK 74133-5716
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 3484 Oklahoma

Profile Details

NPI number 1093795510
LBN Legal business name Pond, Clell W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093795510 NPPES
Oklahoma MEDICAID 100096560C

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