| Mobile Physician's Office Llc | |
|
3941 N Pine Ave Broken Arrow OK 74012-0459 | |
| (918) 760-2200 | |
| (918) 615-6556 |
| Full Name | Mobile Physician's Office Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3941 N Pine Ave, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Tandaleo Gamble (CEO) |
| Authorized Official Contact | 9187602200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Physician's Office Llc 3941 N Pine Ave Broken Arrow OK 74012-0459 Ph: (918) 760-2200 | Mobile Physician's Office Llc 3941 N Pine Ave Broken Arrow OK 74012-0459 Ph: (918) 760-2200 |
| NPI Number | 1700170222 |
|---|---|
| Provider Enumeration Date | 06/01/2011 |
| Last Update Date | 06/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700170222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 13177 (Oklahoma) | Primary |
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