Healthcare Provider Details
I. General information
NPI: 1578855094
Provider Name (Legal Business Name): ACCIDENT MEDICAL ASSOCIATES, PPLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
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
- Phone: 405-609-6600
- Fax: 405-634-1177
- Phone: 405-609-6600
- Fax: 405-634-1177
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081N0008X |
| Taxonomy | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | 3248 |
| License Number State | OK |
VIII. Authorized Official
Name: DR.
CLAYTON
KEITH
MUSE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 405-609-6600