| Geo Chacko Md Pc | |
|
901 N Porter Ave Norman OK 73071-6404 | |
| (405) 307-1000 | |
| (405) 307-6660 |
| Full Name | Geo Chacko Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 901 N Porter Ave, Norman, Oklahoma |
| Authorized Official Name and Position | Geo Chacko (PHYSICIAN) |
| Authorized Official Contact | 9183299153 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geo Chacko Md Pc Po Box 6023 Norman OK 73070-6023 Ph: (918) 329-9153 | Geo Chacko Md Pc 901 N Porter Ave Norman OK 73071-6404 Ph: (405) 307-1000 |
| NPI Number | 1982891362 |
|---|---|
| Provider Enumeration Date | 09/28/2007 |
| Last Update Date | 03/13/2015 |
| Medicare PECOS PAC ID | 4688560352 |
|---|---|
| Medicare Enrollment ID | O20040227000651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982891362 | NPI | - | NPPES |
| 200021120B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 23682 (Oklahoma) | Primary |
| Provider Name | Geo Philips P Chacko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700842440 PECOS PAC ID: 8921994690 Enrollment ID: I20040305000202 |
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