Healthcare Provider Details

I. General information

NPI: 1518132018
Provider Name (Legal Business Name): ALLIED PHYSICIAN'S GROUP INC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13316 S WESTERN AVE SUITE M
OKLAHOMA CITY OK
73170-7302
US

IV. Provider business mailing address

13316 S WESTERN AVE SUITE M
OKLAHOMA CITY OK
73170-7302
US

V. Phone/Fax

Practice location:
  • Phone: 405-495-5154
  • Fax: 405-603-2313
Mailing address:
  • Phone: 405-495-5154
  • Fax: 405-603-2313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number600522049
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JAMIE A BILLINGSLEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 405-495-5154