Healthcare Provider Details

I. General information

NPI: 1669579389
Provider Name (Legal Business Name): MEDICAL SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 N PORTLAND SUITE 220
OKLAHOMA CITY OK
73112-2082
US

IV. Provider business mailing address

5401 N PORTLAND SUITE 220
OKLAHOMA CITY OK
73112-2082
US

V. Phone/Fax

Practice location:
  • Phone: 405-604-4321
  • Fax: 405-604-4331
Mailing address:
  • Phone: 405-604-4321
  • Fax: 405-604-4331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN STUART BOCK
Title or Position: PRESIDENT
Credential: MD
Phone: 405-604-4321