Healthcare Provider Details

I. General information

NPI: 1669681060
Provider Name (Legal Business Name): BONE AND JOINT MANAGEMENT CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N DEWEY AVE
OKLAHOMA CITY OK
73103-2609
US

IV. Provider business mailing address

1111 N DEWEY AVE
OKLAHOMA CITY OK
73103-2609
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-9671
  • Fax: 405-552-9172
Mailing address:
  • Phone: 405-272-9671
  • Fax: 405-552-9172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number2291
License Number StateOK

VIII. Authorized Official

Name: MS. LINDA KAYE ROBERTS
Title or Position: DIRECTOR, PFS AND ACCESS MANAGEMENT
Credential:
Phone: 405-552-9102