Provider Demographics
NPI:1871520908
Name:SABANGAN, JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:SABANGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1514 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1822
Mailing Address - Country:US
Mailing Address - Phone:580-223-5919
Mailing Address - Fax:580-220-2810
Practice Address - Street 1:1514 MEADOW LN
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1822
Practice Address - Country:US
Practice Address - Phone:580-223-5919
Practice Address - Fax:580-220-2810
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK21321207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F07801Medicare UPIN