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NPI Code Detail

MEDICARE: OKC CAR CRASH CLINIC LLC

MEDICARE: OKC CAR CRASH CLINIC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) Physician
2208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1033922034
Entity Type Code : Organization
Provider Name (Legal Business Name) : OKC CAR CRASH CLINIC LLC
Provider Business Mailing Address
First Line : 4525 S KLEIN AVE STE 900
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3839
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4525 S KLEIN AVE STE 900
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3839
Country : US
Telephone Number : 405-862-7274
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARTIN LOPEZ
Credential : MD
Telephone Number : 405-862-7274
Provider Enumeration Date : 01/31/2025
Last Update Date : 01/31/2025

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Directions to “OKC CAR CRASH CLINIC LLC ” Practice Location

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