| None | |
|
1102 N Main St Owasso OK 74055-5571 | |
| (918) 272-5355 | |
| (918) 272-1475 |
| Full Name | None |
|---|---|
| Speciality | General Practice |
| Location | 1102 N Main St, Owasso, Oklahoma |
| Authorized Official Name and Position | Edward J Sokolosky (OWNER) |
| Authorized Official Contact | 9182725355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 1102 N Main St Owasso OK 74055-5571 Ph: (918) 272-5355 | None 1102 N Main St Owasso OK 74055-5571 Ph: (918) 272-5355 |
| NPI Number | 1205040516 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 12/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205040516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 1402 (Oklahoma) | Primary |
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