MEDICARE: SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC

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
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1457607004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	8100 S. WALKER AVENUE
Second Line	:	BUILDING A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9404
Country	:	US
Telephone Number	:	405-632-4468
Fax Number	:	405-631-4964

Provider Business Practice Location Address
First Line	:	2403 W WRANGLER BLVD
Second Line	:	STE A
City	:	SEMINOLE
State	:	OK
Zip	:	74868-1900
Country	:	US
Telephone Number	:	405-382-4939
Fax Number	:	405-631-4964

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JAMES DAVID MOORE
Credential	:
Telephone Number	:	405-632-4468

Provider Enumeration Date	:	08/01/2012
Last Update Date	:	09/21/2020

Similar Medicare Providers

1750386223 — SEMINOLE MEDICAL CLINIC
Practice Location Address:

2403 W WRANGLER BLVD , STE A
SEMINOLE, OK
74868-1900

Practice Phone: 405-382-4939
Practice Fax: 405-382-4947

1174556054 — DR. HARRY CHAYNE FISHER D.O.
Practice Location Address:

919 JEFFERSON ST
SEMINOLE, OK
74868-1900

Practice Phone: 405-382-0585
Practice Fax: 405-382-5940

1558422337 — DR. SERGIO G DEMIER D.O.
Practice Location Address:

2403 W WRANGLER BLVD STE A
SEMINOLE, OK
74868-1900

Practice Phone: 405-382-4939
Practice Fax: 405-382-4947

1750581336 — CHRISTOPHER VALDOZ DE LEON PT
Practice Location Address:

1900 LONA AVE
SEMINOLE, OK
74868-2053

Practice Phone: 405-343-2391
Practice Fax: 405-382-5433

1912182627 — RONALD EUGENE PAULS PA-C
Practice Location Address:

2403 W WRANGLER BLVD STE A
SEMINOLE, OK
74868-1900

Practice Phone: 405-382-4939
Practice Fax: 405-382-4947

1700033867 — KELLI ANN ROLLINS ARNP
Practice Location Address:

2403 W WRANGLER BLVD STE A
SEMINOLE, OK
74868-1900

Practice Phone: 405-382-4939
Practice Fax: 405-382-4940

Directions to “SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.