| |
2000 N Classen Blvd, Suite S. 100, Oklahoma City, OK 73106-6016 | |
(405) 601-7033 | |
(405) 602-1939 |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner |
Location | 2000 N Classen Blvd, Oklahoma City, Oklahoma |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982139937 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 4123 (Oklahoma) | Secondary |
363L00000X | Nurse Practitioner | R0074731 (Oklahoma) | Primary |
Mailing Address | Practice Location Address |
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2000 N Classen Blvd, Suite S. 100, Oklahoma City, OK 73106-6016 Ph: (405) 601-7033 | 2000 N Classen Blvd, Suite S. 100, Oklahoma City, OK 73106-6016 Ph: (405) 601-7033 |