Healthcare Provider Details

I. General information

NPI: 1295868982
Provider Name (Legal Business Name): ACCIDENT MEDICAL INCORPORATED, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 S WESTERN AVE
OKLAHOMA CITY OK
73139-1801
US

IV. Provider business mailing address

6825 S WESTERN AVE
OKLAHOMA CITY OK
73139-1801
US

V. Phone/Fax

Practice location:
  • Phone: 405-609-6600
  • Fax: 405-634-1177
Mailing address:
  • Phone: 405-609-6600
  • Fax: 405-634-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. C KEITH MUSE
Title or Position: PARTNER
Credential: D.C.
Phone: 405-609-6600