Healthcare Provider Details
I. General information
NPI: 1063891000
Provider Name (Legal Business Name): GION ANESTHESIA SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
419 W GRAY ST
NORMAN OK
73069-7117
US
IV. Provider business mailing address
1125 N PORTER AVE STE 301
NORMAN OK
73071-6446
US
V. Phone/Fax
- Phone: 405-809-4200
- Fax: 405-364-5379
- Phone: 405-217-1124
- Fax: 405-292-9491
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PHILIP
C
BIRD
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 405-217-1124