Healthcare Provider Details

I. General information

NPI: 1790301711
Provider Name (Legal Business Name): MARCUS D MAJOR SR. RRT,RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W WILSHIRE BLVD STE A
OKLAHOMA CITY OK
73116-7702
US

IV. Provider business mailing address

415 W WILSHIRE BLVD STE A
OKLAHOMA CITY OK
73116-7702
US

V. Phone/Fax

Practice location:
  • Phone: 405-840-5272
  • Fax: 405-840-5274
Mailing address:
  • Phone: 405-840-5272
  • Fax: 405-840-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number3537
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: