Healthcare Provider Details

I. General information

NPI: 1730109810
Provider Name (Legal Business Name): MICHAEL J SARWINSKI CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 S MAIN ST
GROVE OK
74344-5304
US

IV. Provider business mailing address

PO BOX 451735
GROVE OK
74345-1735
US

V. Phone/Fax

Practice location:
  • Phone: 918-786-2243
  • Fax: 918-787-6052
Mailing address:
  • Phone: 918-787-8980
  • Fax: 918-787-6052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR0082027
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: