Provider Demographics
NPI:1174397905
Name:ERIN N GORANSON MD PLLC
Entity type:Organization
Organization Name:ERIN N GORANSON MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:GORANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-831-2569
Mailing Address - Street 1:2592 SEDONIA CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7558
Mailing Address - Country:US
Mailing Address - Phone:405-831-2569
Mailing Address - Fax:
Practice Address - Street 1:1000 N LEE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1036
Practice Address - Country:US
Practice Address - Phone:806-355-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty