Healthcare Provider Details

I. General information

NPI: 1013964659
Provider Name (Legal Business Name): CENTRAL OKLAHOMA ANESTHESIA & PAIN MANAGEMENT SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 SW 44TH ST SUITE 100
OKLAHOMA CITY OK
73109-3609
US

IV. Provider business mailing address

1044 SW 44TH ST SUITE 600
OKLAHOMA CITY OK
73109-3609
US

V. Phone/Fax

Practice location:
  • Phone: 405-636-1701
  • Fax: 405-631-4891
Mailing address:
  • Phone: 405-631-4263
  • Fax: 405-631-4891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberN/A
License Number StateOK

VIII. Authorized Official

Name: MR. ERNEST THORPE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 405-631-4263