Healthcare Provider Details

I. General information

NPI: 1831142967
Provider Name (Legal Business Name): BAPTIST CARDIOLOGY SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 NW 56TH ST 400
OKLAHOMA CITY OK
73112-4455
US

IV. Provider business mailing address

DEPT 96-0372
OKLAHOMA CITY OK
73196-0372
US

V. Phone/Fax

Practice location:
  • Phone: 405-951-4360
  • Fax: 405-951-4359
Mailing address:
  • Phone: 405-951-4360
  • Fax: 405-951-4359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG MEYERS
Title or Position: CEO
Credential:
Phone: 405-951-4360