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1770513442
SOPUKRO W TIENABESO
MCALESTER, OK
NPI
1770513442
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OK 24308)
Enumeration Date
2006-07-05
Last Update Date
2007-07-08
Business Address
-- SOPUKRO W TIENABESO M.D.
1 E CLARK BASS BLVD
MCALESTER, OK 74501-4209
Phone number: 918-426-1800
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Mailing Address
-- SOPUKRO W TIENABESO M.D.
1316 NW 170TH ST
EDMOND, OK 73003-7410
Phone number: 405-285-0796
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