Healthcare Provider Details
I. General information
NPI: 1932038379
Provider Name (Legal Business Name): OKLAHOMA SPINE SURGERY CENTER PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13313 N MERIDIAN AVE STE B
OKLAHOMA CITY OK
73120-8316
US
IV. Provider business mailing address
13313 N MERIDIAN AVE STE B
OKLAHOMA CITY OK
73120-8316
US
V. Phone/Fax
- Phone: 405-849-6979
- Fax: 405-849-9264
- Phone: 405-849-6979
- Fax: 405-849-9264
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TERRA
PAPPE
Title or Position: ADMINISTRATOR
Credential:
Phone: 405-849-6979