| Oklahoma Shoulder Center, Pllc | |
|
725 Nw 11th St Oklahoma City OK 73103-2429 | |
| (626) 590-6036 | |
| Not Available |
| Full Name | Oklahoma Shoulder Center, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 725 Nw 11th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Elizabeth Nolan (PRESIDENT AND CEO) |
| Authorized Official Contact | 6265906036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oklahoma Shoulder Center, Pllc 725 Nw 11th St Oklahoma City OK 73103-2429 Ph: () - | Oklahoma Shoulder Center, Pllc 725 Nw 11th St Oklahoma City OK 73103-2429 Ph: (626) 590-6036 |
| NPI Number | 1851777544 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 08/04/2015 |
| Medicare PECOS PAC ID | 2264742956 |
|---|---|
| Medicare Enrollment ID | O20151109002291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851777544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 30929 (Oklahoma) | Primary |
| Provider Name | Elizabeth M Nolan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831319938 PECOS PAC ID: 7810183670 Enrollment ID: I20151109002423 |
| Provider Name | Angela T Essary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265074975 PECOS PAC ID: 9436583465 Enrollment ID: I20191230001173 |
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